The following article features coverage from the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting. Click here to read more of Oncology Nurse Advisor‘s conference coverage.

Implementation of a program that initiated a multidisciplinary response to suspicious lung nodules was associated with improvements in follow-up imaging. This and other findings were presented in a poster at the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting by Harpreet Singh, MD, of Froedtert and the Medical College of Wisconsin in Milwaukee, and colleagues.

The program, called “Nodule Net,” is a multidisciplinary program instituted in 2017 to improve management of suspicious lung modules. With Nodule Net, upon encountering a suspicious nodule, a radiologist sends an electronic medical record notification to a centralized nurse navigator. The nurse navigator enters the patient into a follow-up database and provides outreach to the patient’s primary care provider, with reminders if follow-up has not occurred. Referrals are also generated as needed, and additional steps may be involved.

In the presentation, Dr Singh reported 2398 computed tomography (CT) scans were reviewed. Details regarding multiple patient and procedural parameters were collected, including follow-up recommendations. The research team compared the rate of follow-up with this program to historical rates from prior to the implementation of Nodule Net.

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Of the evaluated CT scans, 1367 (57%) had lung nodules reported. From these, 632 (46.2%) were recommended for follow-up imaging, and program navigators received reports for 523 (82.8%) of those recommended for follow-up. The researchers found a significantly higher rate of follow-up completion with patients referred through the Nodule Net program (78%) than was seen with prior standard of care (36.8%; prevalence ratio, 2.90; 95% CI, 2.65-3.18).

Outcomes for patients seen through the new program included a need for outreach in 116 cases (28.4%), of which a malignancy was detected in 4 cases (3.4%). Referrals due to increased nodule size were needed in 17 cases (17.4%).

The researchers concluded that implementation of the multidisciplinary Nodule Net program resulted in a significantly greater completion rate for recommended follow-up imaging. They also suggested that the use of artificial intelligence may improve detection and care for suspicious lung nodules.

Read more of Oncology Nurse Advisor’s coverage of the 2021 ASCO Annual Meeting by visiting the conference page.


Singh H, Jani C, Rupal A, et al. Nodule Net: a prospective safety net program to reduce loss to follow-up and increase early detection of lung cancer. J Clin Oncol. 2021;39(suppl 15; abstr 1564). doi:10.1200/JCO.2021.39.15_suppl.1564