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David S. Ettinger, MD, FACP, FCCP


Do Patients at High Risk for Lung Cancer Experience Delays in Follow-up Screening?

By: Kayci Reyer
Posted: Tuesday, May 24, 2022

According to research presented at the American Thoracic Society (ATS) 2022 International Conference in San Francisco (Session C99), nearly half of patients who are considered at high risk for developing lung cancer after CT screening may experience delayed follow-up care. In fact, nearly half (47%) of exams with high-risk Lung-RADS (Lung Imaging Reporting and Data System) resulted in delays in care.

“It is disconcerting to see that among those screened who have abnormal findings, there is a significant delay in recommended follow-up,” noted Alwiya Ahmed, MD, of the University of Washington, in an ATS press release. “Interventions are needed at both the provider and patient levels to ensure that high-risk patients receive adequate follow-up.”

The retrospective study included 397 patients who underwent baseline and annual lung cancer screening in Seattle between 2012 and January 2021. Among those patients, 464 exams resulted in high-risk findings, and 47% of patients with suspicious findings on CT imaging did not return for additional imaging or consultation within 30 days of the recommended follow-up date. Arranged from low- to high-risk, patient subgroups included Lung-RADS3, Lung-RADS4A, and Lung-RADS4B/4X. The median length of follow-up delay was 92 days overall and 181 days, 68 days, and 32 days for the Lung-RADS3, Lung-RADS4A, and Lung-RADS4B/4X groups, respectively. Patients who were current smokers experienced longer delays than those who formerly smoked. A total of 59 patients (15%) were eventually diagnosed with lung cancer.

“Further study is needed to evaluate the impact of delay in diagnosis after lung cancer screening  on lung cancer stage and survival,” the investigators concluded.

Disclosure: For full disclosures of the study authors, visit

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