肺结节经常在用于肺癌筛查的低剂量计算机断层扫描中被发现，并且在出于其他原因进行的成像中偶然发现。全科医生和亚专科医生对肺结节的治疗方式存在很大差异，与指南不一致的护理比例很高。这可能部分归因于当前实践指南建议的证据水平（主要基于诊断准确性的非对照研究的结果）。肺结节管理的主要目的是最大限度地减少诊断评估的危害，同时加快肺癌的评估、诊断和治疗。由于可用性、可访问性和/或提供者知识有限，诸如肺癌概率计算器、在电子健康记录中识别患有结节的患者的自动化方法以及多学科团队评估等潜在有用的工具通常未得到充分利用。最后，对于识别和减少筛查发现或偶然发现肺结节的个体之间的差异相对较少的关注。这项对美国癌症协会国家肺癌圆桌会议战略计划的贡献旨在识别和描述肺结节管理中的这些知识差距，并提出推进临床实践和研究的建议。讨论的主要主题包括提高支持肺结节评估指南的证据质量、战略性地利用信息技术以及强调公平的结节管理方法。该战略计划中概述的建议通过以健康公平为重点的跨学科努力来实施，最终旨在改善肺癌的早期发现并降低其发病率和死亡率。通俗语言摘要：肺结节可以通过接受肺癌筛查的个体（筛查检测到的结节）或因其他原因进行扫描的患者（偶然结节）的胸部扫描来识别。尽管绝大多数肺结节不是肺癌，但采用基于证据的标准化方法来评估和管理肺结节非常重要。肺结节管理的主要目的是在肺癌处于早期阶段时进行诊断，并避免不必要的手术和其他伤害。© 2024 作者。 《癌症》由 Wiley periodicals LLC 代表美国癌症协会出版。

Lung nodules are frequently detected on low-dose computed tomography scans performed for lung cancer screening and incidentally detected on imaging performed for other reasons. There is wide variability in how lung nodules are managed by general practitioners and subspecialists, with high rates of guideline-discordant care. This may be due in part to the level of evidence underlying current practice guideline recommendations (primarily based on findings from uncontrolled studies of diagnostic accuracy). The primary aims of lung nodule management are to minimize harms of diagnostic evaluations while expediting the evaluation, diagnosis, and treatment of lung cancer. Potentially useful tools such as lung cancer probability calculators, automated methods to identify patients with nodules in the electronic health record, and multidisciplinary team evaluation are often underused due to limited availability, accessibility, and/or provider knowledge. Finally, relatively little attention has been paid to identifying and reducing disparities among individuals with screening-detected or incidentally detected lung nodules. This contribution to the American Cancer Society National Lung Cancer Roundtable Strategic Plan aims to identify and describe these knowledge gaps in lung nodule management and propose recommendations to advance clinical practice and research. Major themes that are addressed include improving the quality of evidence supporting lung nodule evaluation guidelines, strategically leveraging information technology, and placing emphasis on equitable approaches to nodule management. The recommendations outlined in this strategic plan, when carried out through interdisciplinary efforts with a focus on health equity, ultimately aim to improve early detection and reduce the morbidity and mortality of lung cancer. PLAIN LANGUAGE SUMMARY: Lung nodules may be identified on chest scans of individuals who undergo lung cancer screening (screening-detected nodules) or among patients for whom a scan was performed for another reason (incidental nodules). Although the vast majority of lung nodules are not lung cancer, it is important to have evidence-based, standardized approaches to the evaluation and management of a lung nodule. The primary aims of lung nodule management are to diagnose lung cancer while it is still in an early stage and to avoid unnecessary procedures and other harms.© 2024 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.