About Us

About IDEAL Study

What is incidental pulmonary nodules

Our Concept

What Is IDEAL Study

Lung cancer continues to be the most diagnosed cancer and the leading cause of cancer deaths globally. Low-dose computed tomography (LDCT) screening has demonstrated 20-30% of lung cancer mortality reduction, mainly through lung cancer diagnosis at early stages when the prognosis is more favorable. Organized LDCT screening program is the most effective way for lung cancer early detection for those who are at high risk of lung cancer. Some lung cancers occur in people who do not meet the current LDCT screening criteria, which focuses on heavy and long-term tobacco smokers.

IDEAL (Improving Detection of Early Lung cancer in a diverse population) study is a research program focused on incidental pulmonary nodules and lung cancer early detection. It is a multi-province program in British Columbia, Ontario and Quebec, with the goal to develop innovative tools to improve lung cancer early detection through non- or minimally invasive approaches such as breath and blood tests. We are enrolling patients with incidental pulmonary nodules, including those who might not fit the current lung cancer screening criteria, and those who might not have regular access to the health care system.

What is Incidental Pulmonary Nodules

Lung nodules found incidentally (on a scan done for another purpose, such as for coronary heart disease investigation or in the emergency setting for diagnostic purposes) are termed incidental pulmonary nodules (IPNs). IPNs are quite common and occur in about 30% of people. Most IPNs are non-cancerous (benign) and will remain that way. However, a small number (approximately 4-5%) of IPNs may turn out to be an early cancer. Unfortunately, majority (approximately 80%) of IPNs are not being monitored with repeat CT scans to check for growth, therefore an early cancer can be missed.

The IDEAL study is using creative solutions to ensure most IPNs are monitored until they are either considered benign and no longer require continuous monitoring, or an early cancer is diagnosed and treated. Patients with IPNs participating in the IDEAL study will be monitored according to the current clinical guidelines by the team physicians. In addition, our research team are developing novel tools using breath and blood biomarkers to improve detection of early lung cancer. When lung cancer is found in its very early stages, it is likely to respond well to the treatment.

References:
–    Osarogiagbon RU, et al. Lung Cancer Diagnosed Through Screening, Lung Nodule, and Neither Program: A Prospective Observational Study of the Detecting Early Lung Cancer (DELUGE) in the Mississippi Delta Cohort. J Clin Oncol. 2022;40(19):2094-2105
–    Pyenson BS BC et al. No Apparent Workup for most new Indeterminate Pulmonary Nodules in US Commercially-Insured Patients. J Health Econ Outcomes Res. 2019;6(3):118-129.
–    Leung C et al. Current Practice in the Management of Pulmonary Nodules Detected on Computed Tomography Chest Scans. Canadian Respiratory Journal. 2019;2019:9719067.

How Is Lung
Cancer Diagnosed?

Seeing how it looks on the CT scan
Seeing whether it grows over time
A nodule that grows larger over time is a sign that it could be a cancer
Taking a sample of the nodule with a needle or surgery

What Happens Next

Your healthcare team will probably recommend getting more CT scans to keep a close eye on the nodule to see if it changes. We call this “active surveillance.

If a nodule is not cancer, it usually won’t grow. If the nodule doesn’t grow over a 2-year period, it is very unlikely to be cancer. Most of the time, it is safe to stop watching nodules if there is no growth over a 2-year period.

On the other hand, if the nodule is getting bigger, it should be looked at more closely to see if it is lung cancer. Nodules can be viewed more closely using different radiology studies or by biopsy (using a needle or surgery to take a sample of the nodule to look at under a microscope). Your healthcare team will determine which is best for you.

What If My Nodule Is Lung Cancer

Even if a nodule turns out to be lung cancer, it is likely to be an early stage lung cancer. People with early stage lung cancer that is treated are less likely to die than people who are diagnosed at a later stage when the cancer has started to cause symptoms. Your healthcare team will be with you every step of the way.