Lung nodules

Specialty: Respiratory
Age group: Adult

Criteria for referral to public hospital service

• High and very-high risk lung nodule(s) found on imaging.

Information to be included in the referral

Information that must be provided

• Age
• Relevant medical history and comorbidities including any cancer(s) or underlying lung diseases (e.g. chronic obstructive pulmonary disease (COPD), interstitial lung disease)
• Details of relevant family history of lung cancers
• If the lung nodules are detected through the National Lung Cancer Screening Program (NLCSP), a copy of the NLCSP report
• Most recent and prior high-resolution chest CT scan and other chest imaging reports (include date and details of the diagnostic imaging practice)
• Current and complete medication history (including anticoagulant medicines or antiplatelet therapy, immunosuppressant medicines, non-prescription medicines, herbs and supplements)
• If the person has already been referred to another respiratory service.

Provide if available

• Smoking history (cigarettes and all forms of tobacco, nicotine, vaping and cannabis)
• History of occupational or environmental exposure risks, or radiotherapy treatment (if relevant)
• Ethnicity
• If the person identifies as an Aboriginal and/or Torres Strait Islander
• If the person is neurodiverse, gender diverse or has a disability
• If the person has a preferred language other than English and if they rely on cultural or linguistic support (e.g. Aboriginal cultural support, an interpreter)
• If the person is part of a vulnerable population.

Additional comments

The Minimum information for referrals to non-admitted specialist services lists the information that should be included in a referral request.

This statewide referral criteria must be used for referrals to public lung nodule clinics offered by Alfred Health, Austin Health, Barwon Health, Bendigo Health, Eastern Health, Grampians Health, Latrobe Regional Health, Melbourne Health, Monash Health, Northern Health, Peninsula Health, St Vincent’s Hospital and Western Health.

Referring clinicians should refer to the National Lung Cancer Screening Program resource on Providing support for lung cancer screening participants and offer psychosocial support and refer to psychosocial services where appropriate.

Referrals for symptomatic patients (i.e. new or changed cough; chest or shoulder pain, shortness of breath, hoarseness’ weight loss or loss of appetite, persistent or recurrent chest infection, fatigue, deep vein thrombosis, abnormal chest signs, finger clubbing) should be directed to respiratory service provided by the health service.

Vulnerable populations include:

• people from culturally and linguistically diverse backgrounds
• older Australians
• carers of people with chronic conditions
• people experiencing socio-economic disadvantage
• people living in remote, or rural and regional locations
• people with a disability
• people with mental illness
• people who are, or have been, incarcerated.

Vulnerable patient groups also include terminally ill patients, patients with experiences of family violence, in out-of-home care, foster care and those in state care.

Where appropriate and available the referral may be directed to an alternative specialist clinic or service.

Referral to a public hospital is not appropriate for

Not applicable