Innovative Approach to Early Lung Cancer Detection: Integrating a Comprehensive Screening Program and an Incidental Pulmonary Nodule Clinic.

[BACKGROUND] Lung cancer (LC) is the leading cause of cancer-related death. Early detection strategies include LC screening (LCS) with low-dose computed tomography (LDCT) and incidental pulmonary nodule clinics (IPNCs). This study describes the structure, workflow, and outcomes of an integrated early diagnosis strategy combining LCS and IPNCs.

[MATERIAL AND METHODS] We conducted a descriptive analysis of a prospective observational study (May 2023-June 2025) implementing an integrated IPNC-LCS model. All IPNC patients underwent initial LC-risk assessment: highly suspicious lesions were referred to a fast-track diagnostic pathway, low-risk patients to primary care (PC), and high-risk individuals to the LCS program. Additional referrals to the LCS program were received from pulmonology clinics and PC. The LCS program followed the I-ELCAP protocol, including LDCT, lung function testing, α1-antitrypsin deficiency (AATD) screening, and smoking cessation support.

[RESULTS] The IPNC evaluated 481 individuals: 30 (6.2%) had suspicious lung lesions, with four stage I LC confirmed; 282 (58.6%) were classified as low-risk; and 150 (31.2%) as high risk of whom 97 were enrolled in LCS. The LCS program also received 199 referrals from PC and 122 from pulmonology clinics, totaling 418 participants at baseline (63.2% male; mean age 63.0 ± 6.43 years; 52.9% former smokers; 39.7% with COPD; 67.9% with emphysema). New diagnoses included emphysema ( = 106), COPD ( = 25), and AATD mutations ( = 95). Smoking cessation referral was accepted by 74% of smokers. LC was detected in 17 participants (4.07%), 14 (82.4%) at stage I, all receiving curative-intent treatment.

[CONCLUSIONS] This integrated IPNC-LCS model achieved high early-stage LC detection and enabled curative treatment, while uncovering unrecognized respiratory comorbidities and promoting smoking cessation.