An unexpected finding highlights the potential of expanding screening criteria beyond traditional smoking history.
RT’s Three Key Takeaways:
- Incidental Nodule Detection: A routine cardiac calcium scoring scan identified an unexpected lung nodule in an asymptomatic 44-year-old non-smoker, leading to an early-stage lung cancer diagnosis.
- Robotic-Assisted Interventions: Physicians used robotic-assisted bronchoscopy to biopsy the growing nodule and performed minimally invasive robotic surgery to resect the affected lung lobe.
- Screening Guideline Evolution: Thoracic specialists note that standard screening guidelines miss patients who fall outside conventional smoking and age thresholds, advocating for universal age-based protocols.
An incidental finding during a routine heart scan led to an early lung cancer diagnosis in a 44-year-old personal trainer and lifelong non-smoker, according to Northwestern Medicine.
Andrea Kerry underwent a routine cardiac calcium scoring computed tomography (CT) scan recommended by her internal medicine physician, Dhaval Thakkar, MD. Although the scan showed a healthy heart, it revealed a small, round nodule in her lung, prompting Dr Thakkar to recommend follow-up imaging in six months.
“I felt fine. I had zero symptoms. I would never have known without that calcium test,” said Andrea Kerry, patient, in a news release.
Robotic Bronchoscopy and Resection
Follow-up imaging six months later revealed that the nodule had doubled in size, according to the health system. Daniel Coomes, DO, a pulmonologist with the Canning Thoracic Institute at Northwestern Medicine Kishwaukee Hospital, performed a robotic-assisted bronchoscopy to biopsy the tissue, confirming a diagnosis of stage one lung cancer.
“What stands out about Andrea’s diagnosis is how subtle it was,” said Daniel Coomes, DO, a pulmonologist with the Canning Thoracic Institute at Northwestern Medicine Kishwaukee Hospital. “She had no symptoms, and her heart scan was otherwise normal. The small lung nodule could easily have been overlooked, but timely follow-up allowed us to confirm the diagnosis early and move quickly with care.”
Two weeks after diagnosis, Andrew Arndt, MD, director of thoracic surgery with the Canning Thoracic Institute at Northwestern Medicine Central DuPage Hospital, performed minimally invasive robotic surgery to resect the lower lobe of Kerry’s left lung. Pathology findings demonstrated that the tumor measured 1.7 centimeters, confirming early-stage disease with no indication for additional adjuvant therapy.
“Andrea’s cancer was found serendipitously, if you will,” said Andrew Arndt, MD, director of thoracic surgery with the Canning Thoracic Institute at Northwestern Medicine Central DuPage Hospital. “She got a cardiac calcium scoring CT that happened to pick this up. If she had not gotten that scan, she would not have qualified for other screening metrics. And there’s no telling at what point this would have been diagnosed.”
“Early diagnosis shifts lung cancer from being one of the deadliest cancers to one we can often treat effectively and even cure,” said Andrew Arndt, MD, director of thoracic surgery with the Canning Thoracic Institute at Northwestern Medicine Central DuPage Hospital, in a news release.
Addressing Screening Gaps in Non-Smokers
The case highlights ongoing diagnostic challenges as clinicians observe an increasing incidence of lung cancer among women and individuals who have never smoked, according to Northwestern Medicine. Conventional screening frameworks rely heavily on advanced age and tobacco exposure history, leaving younger, non-smoking patients excluded from routine protocols.
“Even if 100 percent of eligible patients get screened, we are still missing most lung cancers because they fall outside conventional screening guidelines based on age and smoking history,” said Andrew Arndt, MD, director of thoracic surgery with the Canning Thoracic Institute at Northwestern Medicine Central DuPage Hospital, in a news release.
To address these limitations, Northwestern Medicine established the Lung Health Center at the Canning Thoracic Institute, which integrates advanced imaging, multidisciplinary teams, and expanded screening models designed to detect lung, heart, and bone abnormalities earlier in non-smokers and women. The center plans to evaluate and publish clinical screening data to support broader healthcare guideline updates.
“We moved to universal age-based screening for breast and colon cancer with tremendous success and we need to move to the same approach for lung cancer,” said Ankit Bharat, MD, chief of thoracic surgery and executive director of the Northwestern Medicine Canning Thoracic Institute.
