Introduction
The American College of Radiology (ACR) is expanding the Lung Cancer Screening Registry (LCSR) to include additional data and functionality that will support early lung cancer detection efforts. This expansion will evolve into the Early Lung Cancer Detection Registry (ELCDR) in late 2025.
This article provides an overview of the registry’s evolution, outlines the purpose of the new IPN addition, and highlights the key additions that participants will see in the NRDR portal as part of the transition to the ELCDR.
Background
The LCSR was established to support facilities and clinicians in providing high-quality lung cancer screening (LCS) care and to track performance measures related to screening outcomes. As the registry and lung cancer screening programs have matured, the need for expanded data collection has grown to include the management of actionable incidental pulmonary nodules (IPNs).
The expansion of the LCSR to the Early Lung Cancer Detection Registry (ELCDR) represents an evolution — not a replacement — of the existing registry. All current LCSR functionality, measures, and reporting will remain available. Participants will see the updated name “LCSR & IPN (Early Lung Cancer Detection Registry)” in the NRDR portal, reflecting the integration of the IPN addition.
Early detection of lung cancer remains the most effective way to improve survival rates. The expanded registry will allow the ACR to provide diagnostic performance feedback across both lung cancer screening exams and IPN management, supporting clinicians and healthcare organizations in optimizing patient care and timely follow-up.
The project’s physician co-advisors, Ella Kazerooni, MD, MS, FACR, and Ben Wandtke, MD, MS, are leading this expanded vision in collaboration with the LCSR Committee and the broader lung cancer screening community.
What’s New with ELCDR
The Early Lung Cancer Detection Registry (ELCDR) builds upon the existing LCSR framework with new data elements, measures, and reporting features for IPN management designed to enhance quality improvement efforts and provide a more comprehensive view of lung health.
- Key Differences from LCSR
While the LCSR focuses primarily on patients undergoing low-dose CT lung cancer screening, the ELCDR expands data collection to include patients with actionable incidental pulmonary nodules (IPNs) identified outside of screening exams. This broader scope supports evaluation of diagnostic performance and follow-up management across both screening and incidental findings.
- New Data Elements
The ELCDR introduces additional data fields specific to the IPN module, which capture information about radiology report recommendations, diagnostic workup, and follow-up actions.
- These data elements enable tracking of timely and appropriate management of IPNs.
- For detailed specifications, refer to the IPN Data Dictionary
- IPN Measures
New measures within the ELCDR will focus on evaluating:
- The rate at which indeterminate lung nodules are linked to an appropriate and actionable follow-up recommendation.
- The rate at which recommended follow-up is performed in a timely manner.
- For a full list and description, see IPN Measure
- Expanded Reporting Features
Participants will have access to new and enhanced ELCDR reports within the NRDR portal.
- Reports will include performance feedback for both lung cancer screening and IPN management.
- Benchmarking and trend visualizations will support continuous quality improvement.
To view available reports and descriptions, see IPN Available Report
Participation & Next Steps
- Who Can Participate
Participation in the Early Lung Cancer Detection Registry (ELCDR) is open to all interested facilities. Those currently enrolled in the Lung Cancer Screening Registry (LCSR) can participate in the full ELCDR (including IPN workflow) without additional fees.
- How To Get Started with ELCDR
Current LCSR participants will automatically have access to the ELCDR module within the NRDR portal once it is launched.
- No separate registration or new agreement is required for LCSR users.
- Facilities may continue submitting LCSR data and begin submitting IPN data at any time.
- Additional training materials and support articles will guide users through new submission workflows and reporting options.
New facilities interested in participating in the ELCDR will need to register by creating a NRDR account or adding the registry to a current account. Apply to the NRDR here.
- Helpful Links and Resources
To support you during this expansion, the following resources will be available:
For any additional questions or support please submit a NRDR support ticket.