Shortening follow-up times for Lung-RADS 3 (probably benign) from six months to five leads to better mortality reduction outcomes, according to a study by a group of researchers led by Mehrad Bastani, Ph.D. of Stanford University.

The team used the Lung Cancer Outcome Simulator “to estimate population-level outcomes of alternative diagnostic follow-up intervals for Lung-RADS categories 3 and 4A. The Lung Cancer Outcome Simulator is a microsimulation model developed within the Cancer Intervention and Surveillance Modeling Network Consortium to evaluate outcomes of national screening guidelines. Here, among the evaluated outcomes are percentage of mortality reduction, screens performed, lung cancer deaths averted, screen-detected cases, and average number of screens and follow-ups per death averted.”

Findings showed that the 3-month follow-up recommendation for Lung-RADS 4 was “optimal,” according to the authors. “However, for Lung-RADS category 3, a 5-month, instead of the recommended 6-month, follow-up interval yielded a higher mortality reduction (0.08% for men versus 0.05% for women), and a higher number of deaths averted (36 versus 27), a higher number of screen-detected cases (13 versus 7), and a lower number of combined low-dose CTs and diagnostic follow-ups per death avoided (8 versus 5), per one million general population. Sensitivity analysis of nodule progression threshold verifies a higher mortality reduction with a 1-month earlier follow-up for Lung-RADS 3,” they continued.

The conclusion that Bastani, et al, reached is that “[o]ne-month earlier diagnostic follow-ups for individuals with Lung-RADS category 3 nodules may result in a higher mortality reduction and warrants further investigation.”

Sources:

Mehrad Bastani,Iakovos Toumazis,Julien Hedou’,Ann Leung,Sylvia K. Plevritis. “Evaluation of Alternative Diagnostic Follow-up Intervals for Lung Reporting and Data System Criteria on the Effectiveness of Lung Cancer Screening.” Journal of the American College of Radiology. Available online August 19, 2021. DOI:https://doi.org/10.1016/j.jacr.2021.08.001 Accessed September 14, 2021, at https://www.jacr.org/article/S1546-1440(21)00642-6/fulltext#secsectitle0010

Yee, Kate. “Shorter follow-up for lung lesions equals better outcomes.” AuntMinnie.com. August 30, 2021. Accessed September 14, 2021, at https://www.auntminnie.com/index.aspx?sec=sup&sub=cto&pag=dis&ItemID=133331