RESEARCH ARTICLE Effectiveness of a protocolized system to alert pulmonologists of lung cancer radiological suspicion V. Leiro-Ferna ´ndez • M. Botana-Rial • A. Tilve-Go ´mez • C. Represas-Represas • A. Pallare ´s-Sanmartı ´n • A. Ferna ´ndez-Villar Received: 16 October 2012 / Accepted: 2 April 2013 Ó Federacio ´n de Sociedades Espan ˜olas de Oncologı ´a (FESEO) 2013 Abstract Purpose When lung cancer (LC) is suspected in chest radiography, an adequate interpretation and management by experts would improve the selection, the access to rapid diagnostic units, the diagnostic effectiveness and prevent the loss of patients with suspected LC. To ensure this, we planned a system for alerting pulmonologists by radiolo- gists to radiological suspicion of LC. Methods This system consists of an alert from radiolo- gists to pulmonologists through a specific email. The pul- monologists alerted has to contact the study doctor petitioner who must refer the patient for study to the Lung Cancer Rapid Diagnostic Unit (LCRDU). We have pro- spectively analyzed all patients studied in a 2-year period including clinical variables, time invested in the different diagnostic steps and the degree of collaboration and satis- faction among the involved professionals. Results Of 118 alerts received, 84 (71 %) were studied in our LCRDU. The median of days until petitioner contact, patient consulted at LCRDU and to obtain a diagnosis was 1 (IQR 0–1.5), 2 (IQR 1–5) and 13 (IQR 7.5–30), respec- tively. In 45 cases (53 %), the suspicion of malignancy was confirmed (LC 84.4 % and metastasic 10.1 %). After staging was complete, 33 % of non-small cell lung cancer was potentially resectable (clinical TNM stage I–II). The level of satisfaction was high so that only one of the petitioner’s studies chose other diagnostic pathways. Conclusion This strategy for radiological suspicion of LC ensures the communication between general practitioners, radiologists and pulmonologist improving the LC diag- nostic effectiveness. This system can be easily imple- mented in health care systems. Keywords Lung cancer diagnosis Á Lung cancer primary care Á Lung cancer suspicion Á Chest radiography Á Rapid diagnosis Á Alert system Introduction Lung cancer (LC) is the most frequent cause of death from cancer, probably due to the frequent presentation of an advanced stage of disease [1]. In most cancers, the initial investigation is chest radiography and normally requested by a general practitioner [2]. At this step, patients with a suspicion of LC should be referred to pulmonary specialists who coordinate the complex diagnostic processes that require more specialists [2]. Most health systems have implemented rapid diagnostic units given its proven effi- cacy in reducing the delay, since the patient is seen in the unit and the diagnosis of LC and in reducing costs to conduct the study an outpatient basis. However, there are few interventions aimed at improving the step before being referred to specialised units to avoid delays in primary care, loss of patients or inadequate hospitalisation. And also, the selection of patients with suspected LC well established could reduce the pressure care at this level and contribute to saving resources. After chest radiography, V. Leiro-Ferna ´ndez Á M. Botana-Rial Á C. Represas-Represas Á A. Ferna ´ndez-Villar (&) Pulmonary Service, Complexo Hospitalario Universitario de Vigo (CHUVI), c/Pizarro 22, 36204 Vigo, Pontevedra, Spain e-mail: alberto.fernandez.villar@sergas.es A. Tilve-Go ´mez Radiology Service, Complexo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain A. Pallare ´s-Sanmartı ´n Pulmonary Service, Complexo Hospitalario de Pontevedra (CHOP), Vigo, Spain 123 Clin Transl Oncol DOI 10.1007/s12094-013-1042-0