Recommendations

Document Overview

Design and created by Guideline Central in participation with the American College of Chest Physicians.

Establishing The Diagnosis Of Lung Cancer: Diagnosis And Management Of Lung Cancer

American College of Chest Physicians

Publication Date: May 1, 2013

Page Last Updated: May 5, 2026

Grading Recommendations

Grade	Description
1	Recommendation: indicates confidence that the benefits of the intervention clearly outweigh harms.
2	Suggestion: indicates greater uncertainty: although the benefits of the statement are still viewed as outweighing the harms, balance of benefits and harms is more difficult to judge, or the benefits or the harms may be less clear. With a suggestion, patient values and preferences may be more variable, and this can influence the clinical decision that is ultimately made.
Grade	Strength of Evidence
A	High: high confidence that the evidence reflects the true effect. Further research is very unlikely to change our confidence in the estimate of effect.
B	Moderate: moderate confidence that the evidence reflects the true effect. Further research may change our confidence in the estimate of effect and may change the estimate.
C	Low: low confidence that the evidence reflects the true effect. Further research is likely to change our confidence in the estimate of effect and is likely to change the estimate.

Document Overview

Document Title: Establishing The Diagnosis Of Lung Cancer: Diagnosis And Management Of Lung Cancer

Authoring Society: American College of Chest Physicians

Document Publication Date: May 1, 2013

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: journal.chestnet.org/article/S0012-3692(13)60293-7/fulltext

Source Citation: DOI: https://doi.org/10.1378/chest.12-2353

Document Scope, Criteria, and Use Cases

Document Objectives: Lung cancer is usually suspected in individuals who have an abnormal chest radiograph or have symptoms caused by either local or systemic effects of the tumor. The method of diagnosis of lung cancer depends on the type of lung cancer (small cell lung cancer or non-small cell lung cancer [NSCLC]), the size and location of the primary tumor, the presence of metastasis, and the overall clinical status of the patient. The objective of this study was to determine the test performance characteristics of various modalities for the diagnosis of suspected lung cancer.

Scope: Assessment and Screening, Diagnosis

Diseases/Conditions (MeSH)

D008175 - Lung Neoplasms

D001999 - Bronchoscopy

D001707 - Biopsy, Needle

D061765 - Endoscopic Ultrasound-Guided Fine Needle Aspiration

D008175 - Lung Neoplasms

D001999 - Bronchoscopy

D001707 - Biopsy, Needle

D061765 - Endoscopic Ultrasound-Guided Fine Needle Aspiration

Keywords: biopsy, bronchoscopy, fine needle aspiration, lung cancer

Target Patient Population: Patients with suspected lung cancer

Inclusion Criteria: Female, Male, Adolescent, Adult, Older Adult

Health Care Settings: Ambulatory, Hospital, Operating and Recovery Room, Outpatient

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Supplemental Methodology Resource: Data Supplement

Number of Source Documents: 247

Literature Search Start Date: Thursday, July 1, 2004

Literature Search End Date: Friday, July 1, 2011

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: Yes

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: Yes

Establishing The Diagnosis Of Lung Cancer: Diagnosis And Management Of Lung Cancer

Recommendations

Diagnosis of Pleural Abnormalities

Diagnosis of Primary Tumor

Grading Recommendations

Document Overview

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology