Clinical calculator summary
Brock (PanCan) Nodule Risk
Clinical calculator summary
Brock (PanCan) Nodule Risk
The Brock (PanCan) model is derived from the Pan-Canadian Early Detection of Lung Cancer Study.
Evidence-based context for fast calculator use
- Purpose:
- Brock PanCan model estimates lung cancer probability in pulmonary nodules detected on CT to guide biopsy versus surveillance decisions.
- Population:
- patients undergoing thoracic oncology risk, staging, or nodule assessment
- Factors:
- Age, Sex, Family History of Lung Cancer?, Emphysema present on CT?, Nodule Size, Nodule Type, Located in Upper Lobe?, Nodule Count
- Reference:
- McWilliams A, et al. Probability of cancer in pulmonary nodules detected on first screening CT. N Engl J Med. 2013;369(10):910-919.
Brock (PanCan) Nodule Risk
Clinical Context & Background
Full model with spiculation (PanCan Model 2b):
Transformed diameter = ((diameter / 10)^-0.5) - 1.58113883
Logit = -6.78917
+ (0.0286687 * (age - 62))
+ (0.6010727 * female)
+ (0.2961090 * family history)
+ (0.2953112 * emphysema)
- (5.3854840 * transformed diameter)
- (0.1276173 * ground-glass nodule)
+ (0.3769578 * part-solid nodule)
+ (0.6581383 * upper-lobe location)
+ (0.7729335 * spiculation)
- (0.0824156 * (nodule count - 4))
Probability = 100 / (1 + e^-Logit)Reference Data
| Risk Probability | Management Suggestion (Fleischner/BTS) |
|---|---|
| < 1% | Very Low Risk. No routine follow-up. |
| 1 - 10% | Low/Intermediate. CT Surveillance (3-12 months). |
| > 10% | High Risk. PET-CT or Biopsy/Resection recommended. |
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
When To Use
- Use Brock (PanCan) Nodule Risk when brock PanCan model estimates lung cancer probability in pulmonary nodules detected on CT to guide biopsy versus surveillance decisions.
- Confirm that the patient, diagnosis, disease phase, and available inputs match the cited model before calculation.
How To Interpret
- Interpret the displayed result using the calculator-specific formula and reference table, spanning < 1% through > 10%.
- A boundary result should prompt input verification and clinical review rather than false precision.
What To Do Next
- Confirm whether the clinical question is screening eligibility, nodule malignancy, staging, or treatment prognosis and move to the corresponding thoracic pathway.
- Document the inputs, result, timing, and clinical context so the assessment can be reproduced.
Limitations
- Lung screening, nodule probability, radiology classification, and cancer staging tools answer different questions.
- The result supports clinician judgment and does not independently determine treatment.
Validated Population
patients undergoing thoracic oncology risk, staging, or nodule assessment
How to apply this result
For a representative case, verify Age, Sex, Family History of Lung Cancer?, calculate the result, and confirm that its classification matches the highlighted reference band before continuing the disease-specific pathway.
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Five source-backed PanCan Model 2b cases were exercised on the published route through visible controls; 5/5 expected results matched, including the <1%, 1%, and just-over-10% presentation transitions.
- No unexpected N/A, literal undefined value, stale control, or browser-console error was observed.
Case-level evidence is retained in validation/browser-revalidation/brock-lung-nodule-malignancy-calculator-2026-08-03.json.
: Local browser remediation verified; production retest pending
- Preserved the verified PanCan Model 2b formula and raw risk classification while preventing one-decimal display rounding from contradicting the <1% and >10% bands.
- Ten local browser cases passed through visible controls, including both cutoff transitions, all nodule types, operational limits, binary predictors, invalid age feedback, and reset/repeat behavior.
- The original failed production-browser record remains open until this change is deployed and the public route passes a new ten-case browser run.
Local diagnostic evidence is retained in validation/browser-production/brock-lung-nodule-malignancy-calculator.local-remediation.json.
: Production browser validation
- Ten source-backed cases were exercised on the public production route through visible browser controls; 9/10 case records passed their expected-versus-observed assertions across 0 visible submissions.
- Overall browser status: failed-ui-and-console. high: A raw probability of 10.0001% renders as `10.0%` while the same card classifies it as `High Risk (>10%)`, producing a visible score-versus-classification contradiction at the threshold. | medium: Production emitted minified React error #418 during route loads/reloads used by this run.
- Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.
Case-level production evidence is retained in validation/browser-production/brock-lung-nodule-malignancy-calculator.json.
: Full validation test
- Rechecked the full PanCan Model 2b equation, workbook cases, operational limits, invalid inputs, raw risk boundaries, and lung-panel parity.
: Correction
- Fixed the PanCan calculation mismatch.
- Added the validated age range: 18-100 years.
- Added the validated nodule-size range: 1-30 mm.
Included in the current validation report.
Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.
Frequently Asked Questions
When should Brock (PanCan) Nodule Risk be used?
Use it for patients undergoing thoracic oncology risk, staging, or nodule assessment when all required inputs and the intended clinical setting are confirmed.
Can Brock (PanCan) Nodule Risk determine treatment by itself?
No. Interpret the result with the cited evidence, complete clinical assessment, current guidelines, and patient-specific goals.
Evidence-based oncology decision support. Verify with clinical guidelines.