A ten-year cohort of incidental findings to calibrate follow-up guidelines
Scans find unexpected lumps in the adrenal, thyroid, pancreas and lung. Nobody knows how many matter. A national cohort following them for ten years would tell us whom to watch.
Incidentaloma guidelines rest on small retrospective series. Propose a national linked cohort enrolling all incidental findings flagged by structured radiology reporting, with registry follow-up, to estimate cancer risk by lesion type, size and patient factors, and to prune guidelines.
- Overdiagnosis and false alarms · Finding more cancer is not the same as saving lives. Screening also finds cancers that would never have hurt anyone, and treats them.
- Weak real-world evidence and registries · We do not reliably know what happens to patients after approval, so we cannot tell which drugs deliver in practice.
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