Advancing the early detection of lung cancer: Outcomes of a surgeon-led lung nodule clinic in a distressed patient population.

Objective: Lung cancer screening and support for guideline-concordant follow-up of incidental pulmonary nodules are critical to identifying lung cancers at an earlier stage. A surgeon-led lung nodule clinic was developed at our institution, which serves a majority-minority population. We describe outcomes of this initiative. Methods: A referral for screen-detected and incidental pulmonary nodules was created within our health system during February 2022. Sociodemographic and clinical data, follow-up rates and outcomes of nodule evaluation were collected from February 1, 2022, to December 31, 2024. Results: During the study period, a total of 1056 referrals were placed for the lung nodule clinic. Of all referrals, 440 were for screen-detected lesions, whereas 616 were for incidental pulmonary nodules. Underrepresented patients accounted for 69.7% (n = 736) of patients, and 342 were Black, whereas 394 were Hispanic. The Distressed Communities Index was also investigated and most patients were categorized as at-risk (n = 478) or distressed (n = 493). In evaluating incidental lesions, 45.9% (n = 283) of patients had nodules >6 mm. In the overall group, positron-emission tomography-computed tomography was recommended for 218 patients, and 143 patients underwent biopsy. Primary lung cancer was diagnosed in 94, of which 59 (62.7%) had stage I disease. Of patients with primary lung cancer, 61 underwent resection with therapeutic intent. A critical stage shift has been identified with stage I diagnoses increasing from 20.2% in 2020 to 35.3% in 2024. Conclusions: Centralized referral for pulmonary nodules has been embraced within our institution. This referral provides a means for efficient work-up, and continued expansion will likely provide aid in early detection.