Neumann Kirill, Berg Janna, Ashraf Haseem, Isaksson Johan, Borg Morten H, Rasmussen Torben R
Pulmonary department, Akershus University Hospital, Norway.
Pulmonary department, Vestfold Hospital Trust, Tønsberg, Norway.
Acta Oncol. 2025 Jan 8;64:22-26. doi: 10.2340/1651-226X.2025.42461.
There is limited data on the real-world management of incidental pulmonary nodules (IPN). In this article, we review current practices and adherence to international guidelines in the Nordic countries.
This non-interventional, observational survey study based on an online survey consisting of 13 questions. In total, 32 hospitals responded to the survey, with 11 from Denmark, 10 from Sweden, 7 from Norway, and 4 from Finland, resulting in an overall response rate of 86% (32/37). These institutions reported following a median of 20 new lung nodules monthly (5-400 IPN cases per month).
In Denmark and Sweden, 100% of respondents indicated the presence of national guidelines. In Norway, this rate was 86%, and in Finland 80%. Among the primary guidelines followed, 70% of respondents reported using national guidelines, 20% used international guidelines, and only 10% reported relying on local/institutional guidelines as their first choice. Most sites used a combination of international and national guidelines (75%, 24/32). Available international guidelines were equally represented, with 35% using the Fleischner Criteria, 30% using British Thoracic Society guidelines, and 35% using others (e.g. European Society for Medical Oncology, National Comprehensive Cancer Network). There was variation in which department held primary responsibility for IPN follow-up. The article also demonstrated differences in suggested follow-up cases from the survey.
The study reveals strong adherence to guidelines among Nordic hospitals, with a notable preference for hybrid approaches that combine different guidelines. We need continued efforts to harmonize and update guidelines.
关于偶然发现的肺结节（IPN）的实际管理的数据有限。在本文中，我们回顾了北欧国家当前的实践情况以及对国际指南的遵循情况。
这项非干预性观察性调查研究基于一项包含13个问题的在线调查。共有32家医院回复了调查，其中丹麦11家，瑞典10家，挪威7家，芬兰4家，总体回复率为86%（32/37）。这些机构报告每月平均跟踪20个新的肺结节（每月5 - 400例IPN病例）。
在丹麦和瑞典，100%的受访者表示存在国家指南。在挪威，这一比例为86%，在芬兰为80%。在遵循的主要指南中，70%的受访者报告使用国家指南，20%使用国际指南，只有10%报告首选依赖当地/机构指南。大多数机构使用国际指南和国家指南的组合（75%，24/32）。可用的国际指南使用情况相当，35%使用弗莱施纳标准，30%使用英国胸科学会指南，35%使用其他指南（如欧洲医学肿瘤学会、美国国立综合癌症网络）。IPN随访的主要责任科室存在差异。本文还展示了调查中建议的随访病例的差异。
该研究表明北欧医院对指南的遵循程度很高，尤其倾向于结合不同指南的混合方法。我们需要持续努力来协调和更新指南。
