1. Lung cancer diagnostic pathway
Harmonising the pathway from suspected lung cancer or incidental imaging finding to referral, CT imaging, staging, tissue diagnosis, molecular testing, MDT review, and treatment decision.
Continuous Nordic harmonisation
NTOG identifies clinical and research protocol areas where Nordic collaboration can support more consistent lung cancer diagnosis, staging, treatment planning, follow-up, data collection, and quality improvement.
The protocol topics below are working areas for harmonisation. They support discussion, collaboration, and future consensus work across Nordic countries.
They do not replace national guidelines, local hospital protocols, regulatory requirements, or clinical judgment.
This is continuous work. Some areas already have active Nordic discussion, pilot activity, meeting outputs, or related research. Other areas remain planned harmonisation topics that will mature through work packages, expert groups, and NTOG meetings.
Status NTOG protocols are living harmonisation topics. Final public documents, consensus statements, templates, and PDF downloads will be added after review and approval.
How we describe progress
Transparent status labels avoid overstating unfinished work while showing progress. This avoids overstating unfinished work while showing progress.
Work started
Already active
Nordic discussion, pilots, research, meetings, or subgroup work already exist.
Active harmonisation
Under development
Topic is being shaped into shared principles, variables, templates, or future protocol documents.
Planned topic
Future work
Topic is recognised as important but needs working-group ownership or additional scoping.
Protocol and harmonisation areas
Working topics under the NTOG umbrella.
2. Standardised care pathway timelines
Comparing and harmonising timeline targets for referral, diagnostic work-up, MDT discussion, surgery, radiotherapy, systemic therapy, and palliative care.
3. Multidisciplinary team meeting protocol
Defining which lung cancer cases should be discussed, required pre-MDT information, core specialties, documentation standards, and decision communication.
4. Pulmonary nodule management
Working toward a Pan-Nordic approach to pulmonary nodule follow-up, risk assessment, radiology reporting, referral thresholds, and diagnostic pathways.
5. Lung cancer screening workflow
Harmonising workflow principles for low-dose CT screening, eligibility, radiology reporting, incidental findings, smoking cessation, follow-up, and referral.
6. Molecular testing protocol
Defining minimum biomarker testing principles, tissue and liquid biopsy workflows, turnaround time targets, reporting standards, and re-testing at progression.
7. Stage III NSCLC work-up and treatment planning
Harmonising staging, PET/CT, brain imaging, mediastinal assessment, pulmonary function testing, surgical assessment, radiotherapy planning, and MDT decision-making.
8. Small-cell lung cancer pathway
Defining Nordic principles for limited-stage and extensive-stage small-cell lung cancer work-up, staging, treatment urgency, radiotherapy, systemic therapy, and follow-up.
9. Quality indicators and registry data
Identifying core Nordic lung cancer quality indicators, registry variables, staging data, MDT data, treatment timelines, treatment intent, and outcome measures.
10. Patient communication templates
Developing clear patient communication templates for CT findings, pulmonary nodule follow-up, screening invitations, incidental findings, MDT decisions, and smoking cessation support.
What has already started
Several protocol areas are already connected to active Nordic discussion, research, or work-package activity.
- Screening and pulmonary nodules: Nordic low-dose CT screening pilots and nodule follow-up workflows create a practical basis for shared comparison and harmonisation.
- Registry data and quality indicators: Nordic registry structures support comparison of timelines, staging, treatment intent, outcomes, and variation in care.
- Clinical studies: NTOG-linked academic studies in small-cell lung cancer and radiotherapy demonstrate the feasibility of Nordic trial collaboration.
- Education: NORTHDIP, the Nordic Lung Cancer Symposium, and working-group meetings provide recurring settings for protocol discussion and training.
- Expert networks: Steering Committee and specialty contacts provide routes for topic ownership and cross-country review.
Future public documents
Final protocols, templates, consensus documents, and PDF downloads will be added after review and approval.
Until then, this page should function as a transparent working overview for Nordic and international collaborators.