Lung Nodule Malignancy Risk Calculator

Predicts likelihood of cancer of the evaluated lung nodules in the next 2 to 4 years.

Refer to the text below the tool for more information on the Brock University cancer prediction equation for multiple and solitary pulmonary nodules (SPN).


The Brock University cancer prediction equation may be used for predicting multiple or solitary pulmonary nodule malignancy risk in adults based on several variables available during the clinical process of checking the pulmonary lesions.

The log of odds and cancer probability determine the malignancy risk of the lesion(s) within the next 2-4 years.


Cancer probability = 100 * (eLog odds / (1 + eLog odds))

Where:

Log odds = (0.0287 x (Age - 62)) + Sex + Family history + Emphysema - (5.3854 x ((Nodule size/10)- 0.5 - 1.58113883)) + Nodule type + Nodule in upper lung - (0.0824 x (Nodule count - 4)) + Spiculation - 6.7892

  • If patient is female, use 0.6011;
  • If emphysema present, use 0.2953;
  • If family history of lung cancer present, use 0.2961;
  • If spiculation present, use 0.7729;
  • If nodule is in upper lung, use 0.6581;
  • If nodule nonsolid or ground-glass, use -0.1276;
  • If nodule partially solid, use 0.377;
  • If nodule solid, use 0.

Age
Gender
Family history of lung cancer
Emphysema
Spiculation
Nodule in upper lung
Nodule count
Nodule size
Nodule type
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Steps on how to print your input & results:

1. Fill in the calculator/tool with your values and/or your answer choices and press Calculate.

2. Then you can click on the Print button to open a PDF in a separate window with the inputs and results. You can further save the PDF or print it.

Please note that once you have closed the PDF you need to click on the Calculate button before you try opening it again, otherwise the input and/or results may not appear in the pdf.


 

Pulmonary Nodule Cancer Probability

This is a simple model developed by McWilliams et al. in 2013 that can be employed in the prediction of malignancy risk of lung nodules based on nodule size, count, consistency and location, as well as patient gender, family history and presence of emphysema.

The Brock University cancer prediction equation may be applied for multiple and solitary pulmonary nodules (SPN):

  • Cancer probability = 100 * (eLog odds / (1 + eLog odds))

Where:

  • Log odds = (0.0287 x (Age - 62)) + Sex + Family history + Emphysema - (5.3854 x ((Nodule size/10)- 0.5 - 1.58113883)) + Nodule type + Nodule in upper lung - (0.0824 x (Nodule count - 4)) + Spiculation - 6.7892

The log of odds and cancer probability determine the malignancy risk of the lesion(s) within the next 2-4 years.

The variables used in the equation above are summarized in the table below:

Variable Discrete value to use in eqn Interpretation
Gender, if female 0.6011 Lung cancer is the leading cause of cancer death in women, with a greater incidence than breast, ovarian, and uterine cancer combined.
Presence of emphysema 0.2953 Emphysema is an aggravating factor
Family history of lung cancer 0.2961 Individuals with first-degree relatives with lung cancer have a 50% increased malignancy risk
Presence of spiculations 0.7729 Lesions present spiculated borders (sunburst or corona radiata)
Nodule in upper lung 0.6581 Lesions located in upper lung are more likely to be malignant
Nodule nonsolid or ground-glass -0.1276 -
Nodule partially solid 0.377
Nodule solid 0

In the process of diagnosing and following up on pulmonary nodules, the growth rate is an important consideration. Malignant nodules can double in size every 4 months (on average), some as quickly as 1 month others as slowly as 15 months. Lung nodule growth rate is evaluated through x-rays or CT investigations.

Whilst benign pulmonary nodules require no treatment, malignant ones are commonly treated by surgical removal. Methods depend on the nodule size, condition and location and may include:

  • Video-assisted thorocoscopic surgery;
  • A mini-thoracotomyis;
  • A full thoracotomyis.
 

References

Original reference

McWilliams A, Tammemagi MC, Mayo JR, et al. Probability of cancer in pulmonary nodules detected on first screening CT. N Engl J Med. 2013; 369(10):910.

Other references

McWilliams A, Mayo J, MacDonald S, et al. Lung cancer screening: a different paradigm. Am J Respir Crit Care Med. 2003; 168:1167–73.

Fox AH, Tanner NT. Approaches to lung nodule risk assessment: clinician intuition versus prediction models. J Thorac Dis. 2020; 12(6):3296-3302.

Hoffman RM, Sanchez R. Lung Cancer Screening. Med Clin North Am. 2017; 101(4):769-785.


Specialty: Oncology

Objective: Risk Prediction

Year Of Study: 2013

Article By: Denise Nedea

Published On: August 28, 2020

Last Checked: August 28, 2020

Next Review: August 28, 2025