Diagnostic Pathways for Lung Cancer

Principal Investigator

Name
Pamela Marcus

Degrees
PhD

Institution
NCI

Position Title
Epidemiologist

Email
marcusp@mail.nih.gov

About this CDAS Project

Study
NLST (Learn more about this study)

Project ID
NLST-1523

Initial CDAS Request Approval
Aug 20, 2026

Title
Diagnostic Pathways for Lung Cancer

Summary
We wish to characterize the pathways to lung cancer diagnosis in the participants who were randomized to the CT arm. We will define the diagnostic pathway as including all clinical encounters from the first suspicion of lung cancer (positive screen, symptom, or other clinical event) through and including confirmed lung cancer diagnosis. Pathways include clinical events such as imagining, blood work, and other tests. We will include any events that lead to a definitive diagnosis of lung cancer, such as resection and pathology. We will not consider any events that occur after a definitive diagnosis. Our goal is to better understand the clinical experiences of participants in the CT arm who were diagnosed with lung cancer during the trial. We intend to publish our findings and share them with the public (including other researchers).

Aims

1. Describe the reasons why patients enter the lung cancer diagnostic pathway. We expect the reasons to include positive screen, symptom presentation, incidental finding due to another clinical event, presentation at the emergency room, and any other)
2. Detemine the frequences of the reasons why patients enter the lung cancer diagnostic pathway (#1 above).
3. Characterize the diagnostic pathways for CT arm patients who are ultimately diagnosed with lung cancer. Examine the order of clinical procedures/events and time between steps in the diagnostic pathways. Identify the most common diagnostic pathways. Develop graphics to display the top 5-10 diagnostic pathways, their frequency of occurrance, and the sequential nature within each pathway.

Collaborators

Pamela Marcus NCI
Liz Sarma NCI
Paul Doria-Rose NCI
Jennifer Croswell NCI