Indications for chest x-ray scan A person should have a chest x-ray scan within 2 working days if he or she presents with any of the following: Hemoptysis New finger clubbing Suspicious lymphadenopathy Dysphagia Features suggestive of cancer metastasis to or from the lung10 Features suggestive of paraneoplastic syndromes10 Or if any of the following unexplained signs or symptoms last more than 3 weeks (patients with known risk factors [Box 1] might be considered sooner): Cough Weight loss or loss of appetite Shortness of breath Chest or shoulder pain Abnormal chest signs (eg, crackles or wheezes) Hoarseness Also consider the following: Patients with underlying chronic respiratory problems should have chest x-ray scans within 3 weeks if they have unexplained changes in existing symptoms A person who has consolidation or unexplained pleural effusion on an initial chest x-ray film should be treated and have a chest x-ray scan repeated within 6 weeks to confirm complete resolution Sputum cytology is not recommended for the investigation of suspected lung cancer Indications for chest CT scan A person should have a chest CT scan within 2 weeks if he or she has either of the following: Abnormal chest x-ray findings (eg, nodules, infiltrates, nonresolving consolidation or effusion despite treatment) suspicious for lung cancer Normal chest x-ray findings, but there is a high suspicion of lung cancer based on clinical judgment The ordering physician will depend on locally available resources and processes for expedited CT scans

CT—computed tomography.