Inclusion Criteria:
- Chest computed tomography report contained [‘nodule’ OR ‘nodules’] AND [‘follow-up’ OR ‘repeat’]
- Age ≥ 35 years
- Domicile in Olmsted County, MN
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Exclusion Criteria:
- Age < 35 years
- Domicile outside of Olmsted County, MN
- Prior history of malignancy other than non-melanoma skin cancer
- Prior history of lung transplantation
- Prior cross-sectional imaging revealed pulmonary nodule
- Detected nodule is outside of the lung
- Patient died of unrelated causes within the recommended follow-up interval
- Subsequent CT chest earlier than Fleischner recommendation for a clinical reason other than the pulmonary nodule(s)
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