OBJECTIVE: The aim of this special report is to describe the 6th edition of "The Guidelines for the Management of Pulmonary Nodules Detected by Low-Dose CT Lung Cancer Screening ". METHODS: Since the 5th edition six years ago, a review of the literature and consideration of consistency with new evidence led to the revision of the 6th edition. RESULTS: The main revisions in the 6th edition can be summarized as follows: 1) addition of the section "Recommendations for Low-Dose CT Lung Cancer Screening in Japan"
2) change in the recommended solid component diameter, and follow-up interval for nodules with a total mean diameter of less than 15 mm and a solid component diameter of less than 8 mm
3) replacement of the recommended case images
and 4) introduction of the criteria of the Accreditation Council for Lung Cancer CT Screening. CONCLUSION: This guideline is gradually gaining acceptance in Japan. This guideline should be applied carefully in clinical practice, considering various factors such as the patient's condition.