Join us as we demystify the world of pulmonary nodules & lung cancer screening. During this episode, Dr. Denitza Blagev (@mybetterdoctor) makes her triumphant return to The Curbsiders to help us tackle this topic. She is currently the Medical Director for Quality/Specialty-Based Care at Intermountain Healthcare and a Pulmonary & Critical Care physician. We learn to take command of the recommendations for lung cancer screening, disambiguate the terms used by pulmonologists and radiologists, and appreciate some of the nuances of lung cancer screening all with the hope of making YOU a better primary care physician! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by:  Cyrus Askin MD & Leah Witt, MD Infographic: Leah Witt, MD Cover Art: Dr. Kate Grant MBChB DipGUMed CME/MOC: Cyrus Askin, MD Hosts: Cyrus Askin MD; Leah Witt, Matthew Watto MD, FACP; Paul Williams MD, FACP    Editors: Matthew Watto MD, FACP (written materials); Clair Morgan of Nodderly.com (audio) Guest: Denitza Blagev, MD Sponsor ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order! Time Stamps 00:00 Sponsor -ACP’s MKSAP 18 http://www.acponline.org/mksapcurbsiders 00:15 Intro, disclaimer, guest bio 02:15 Guest one-liner; Picks of the Week*: Educated (book) by Tara Westover; Cheer, Netflix series; The Witcher, Netflix series; Uptime /  Downtime -album by The 06:24 Sponsor -ACP’s MKSAP 18 http://www.acponline.org/mksapcurbsiders 07:25 Case: Incidental pulmonary nodules; Defining terms: mass vs nodule 15:20 Spiel/Counseling a patient with an  incidental lung nodule; Analogy about skin findings and lung nodules 20:50 Types of nodules, duration of monitoring; Tracking nodules; Recap on incidental pulmonary nodules 27:54 Case: Lung cancer screening (USPSTF, NLST criteria and CMS guidelines); Shared decision making 41:56 Lung-RADS and lung cancer screening; Types of CT scan; When to refer 48:22 Take home points on Lung Cancer screening 52:35 Outro *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on my Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra. Goal Listeners will develop an approach to incidentally found pulmonary nodules, lung cancer screening and what to do with the suspicious lung nodule or mass. Learning objectives After listening to this episode listeners will...   ...be familiar with the differences between nodules & masses and some of the common etiologies for these findings.   ... appreciate the difference between the incidental pulmonary nodule and those found during lung cancer screening and thus the different systems (Fleischner vs. Lung-Rads) used to assess nodules. ... have a framework for how to approach incidental pulmonary nodules, particularly with respect to the 2017 Fleischner Society Guidelines . ... be able to educate peers & patients regarding who qualifies for lung cancer screening and who does not. ... understand what makes a patient “high risk” vs. “standard risk” with respect to incidentally found pulmonary nodules. ... appreciate the background and reasoning behind the current recommendation for lung cancer screening ... discover how to determine follow up of a lung nodule found as part of a lung cancer screening CT using Lung-Rads. ... learn strategies regarding how to discuss incidental nodules and nodules found on screening CTs with patients, as well as how to approach the discussion of whether or not to screen with the use of various readily available resources .