Lung cancer risk

🎯 Nodule Tool

Unifies the two most common frameworks for pulmonary nodules: the Fleischner Society 2017 guidelines for incidentally detected nodules, and ACR Lung-RADS v2022 for nodules found on low-dose CT lung cancer screening. Pick the setting that matches how the nodule was found.

Fleischner 2017 inputs

For incidental nodules in patients ≥ 35 yr, without known cancer, immunocompetent.

High risk: heavy/current smoking, upper-lobe location, older age, spiculation, larger size, emphysema/fibrosis.

Recommendation

Enter nodule details and press the button.
Clinical decision support only. Fleischner 2017 does not apply to patients < 35 years, immunocompromised patients, or those with known/suspected primary cancer; perifissural nodules with a benign morphology need no follow-up even if > 6 mm. Lung-RADS applies to the LDCT screening population only. The Mayo (Swensen 1997), Veterans Affairs (Gould 2007), and Brock (McWilliams 2013) models estimate probability of malignancy and are validated for different populations (Mayo: incidental nodules 4–30 mm in a non-screening cohort; VA: 7–30 mm nodules in a veteran, high-smoking-prevalence cohort; Brock: nodules found at baseline low-dose CT screening in ever-smokers) — applying any outside its derivation population reduces accuracy. This tool summarizes published equations and tables and cannot capture every qualifier — always consult the full source guideline and correlate clinically.

References: MacMahon H, et al. Fleischner Society 2017. Radiology 2017;284:228–243. · ACR Lung-RADS v2022. · Swensen SJ, et al. (Mayo) Arch Intern Med 1997;157:849–855. · Gould MK, et al. (Veterans Affairs) Chest 2007;131:383–388. · McWilliams A, et al. (Brock/PanCan) N Engl J Med 2013;369:910–919.