What is the best approach to a solitary pulmonary nodule identified by chest x-ray?
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Your initial risk assessment should include the patient's smoking history, advancing age, cancer history, and chest radiography features (strength of recommendation [SOR]: A, based on a validated clinical decision rule). You'll also need to review old chest radiographs (SOR: C, based on expert opinion). A solitary pulmonary nodule unchanged for >2 years on chest radiograph or containing benign central calcifi cations requires no further work-up (SOR: B, based on historical cohort studies).
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