Tag: CT lung cancer screening

Doubling Lung Screening Rates with Patient Outreach

Posted on by Brian Casey

Low CT lung cancer screening rates have disappointed medical imaging professionals and public health advocates alike since the test received USPSTF recommendation over 10 years ago. But a new study shows how one health system doubled its lung cancer screening rates – to levels approaching those of more established cancer screening exams. 

USPSTF recommended low-dose CT lung cancer screening in 2013, but 10 years later patient screening rates languished in the mid-teens, compared to rates of around 75% for breast and cervical cancer and above 72% for colorectal cancer. 

  • That means many lung cancer patients are showing up with late-stage disease, when it’s more difficult to cure. Perhaps as a result, lung cancer is expected to cause almost 125k deaths in the U.S. in 2025.

Breaking that cycle was the goal of researchers at the University of Rochester Medical Center in New York, who wrote about their experiences in a study published in NEJM Catalyst. 

  • They wanted to boost lung cancer screening adherence across their network of 42 locations in western New York. 

So how did they do it? Success came through a combination of IT innovation and old-fashioned legwork in patient outreach. Clinicians…

  • Provided evidence on lung cancer screening to primary care providers.
  • Updated their EHR software to identify patients eligible for lung screening based on the daily schedule to provide screening prompts during patient visits.
  • Created dashboards to guide outreach to patients due or overdue for screening exams.
  • Developed an extensive follow-up program with patient navigators to facilitate recall for annual exams.
  • Created a centralized pulmonary team to provide referrals for smoking cessation, conduct shared decision making for screening exams, and manage pulmonary nodules.

The program produced immediate results. In an analysis comparing screening rates in March 2022 to June 2025, researchers found…

  • Lung screening rates doubled (from 33% to 72%).
  • On-time completion of annual LDCT screening exceeded 94%.
  • 78% of lung cancer cases in 2023 and 2024 were diagnosed at an early stage.
  • There were no statistically significant differences in screening rates by patient race.

The Takeaway
The new results match up with recent findings – such as those presented at WCLC 2025 in September – underscoring the importance of reaching out to potential lung cancer screening candidates to bring them into the fold. Despite CT lung screening’s halting history, these studies show that it can be done.

CT Lung Screening Chats Pay Off

Posted on by Brian Casey

Patients who talked about CT lung cancer screening with their doctors were more likely to actually follow through on getting scanned. That’s according to a study this week in CHEST that offers support for shared decision making – a process that some screening proponents have criticized.

The U.S. continues to see disappointing compliance rates for CT lung cancer screening, over 10 years after the USPSTF recommended the exam.

  • Some lung screening proponents suggest that one barrier to screening is a CMS rule requiring a shared decision-making session between patients and doctors before the first scan is performed – a requirement that’s not in place for any of the other major cancer screening tests.

But the new study indicates that shared decision making could actually work to boost compliance. 

  • Researchers from the Harvey L. Neiman Health Policy Institute led by first author YoonKyung Chung, PhD, examined lung screening compliance rates for 22.6k people who had their first CT exam between 2016 and 2019.

Researchers looked at differences in annual follow-up lung screening rates between people who got shared decision-making sessions and those who didn’t, finding… 

  • Only 11% of study participants had a session before their first scan.
  • One year after the initial scan, those who participated in sessions were 27% more likely to get a follow-up exam.
  • Four years later, the compliance rate rose to 33%. 

If CMS requires shared decision-making sessions for reimbursement, why are they occurring so infrequently? 

  • The authors called this phenomenon “puzzling,” and suggested it’s because CMS is not enforcing the mandate through tools like claims denial. CMS could also boost utilization by providing higher reimbursement for the discussions.

The Takeaway

The new findings suggest that shared decision making should be viewed as an opportunity rather than a barrier to convincing patients of CT lung cancer screening’s value. The results track with other studies showing that a high-touch approach with tools like patient navigators can work.

How to Improve CT Lung Screening Outcomes

Posted on by Brian Casey

Getting patients to attend cancer screening exams is one of the biggest challenges in healthcare. But a new study in JAMA Network Open should provide motivation, showing that people who showed up for annual CT lung cancer screening exams had better clinical outcomes than those who didn’t. 

Low cancer screening adherence frustrates clinicians and healthcare policy experts alike, but nowhere is the situation as dire as in CT lung cancer screening.

  • U.S. lung screening adherence rates languished in the single digits for years after the exam was approved by the USPSTF, and while there has been some recent improvement, screening rates are nowhere near those of more established exams like mammography. 

At the same time, statistical modeling studies (and common sense) suggest that complying with screening would reduce lung cancer mortality. 

  • So researchers from multiple institutions in the U.S. and Canada decided to track adherence to a real-world CT lung screening program consisting of a baseline scan and then two follow-up scans roughly a year apart. 

In all, 10.2k eligible adults were screened from 2015 to 2018, with researchers finding …

  • Screening adherence rates fell from the first follow-up round to the second (61% to 51%).
  • People who attended the first follow-up round were more likely to attend the second (67% vs. 25%). 
  • Patients who completed both screening rounds had higher lung cancer diagnosis rates (1% vs. 0.2%).
  • Patients who attended the second round and got a lung cancer diagnosis were more likely to have early-stage disease (73% vs. 25%) and less likely to have late-stage disease (21% vs. 58%). 

In analyzing the results, researchers said the drop-off in adherence rates between the first and second follow-up screening rounds represented an opportunity to reach out to people who missed the first round and get them to the second.

  • This position dovetails with other recent research underscoring the importance of patient navigators in guiding eligible people to lung cancer screening. 

The Takeaway

So as radiology and other disciplines look to build on the momentum behind CT lung cancer screening, what’s the key to success in improving patient outcomes? Sometimes, it’s just getting people to show up. 

Are CT Lung Screening Patients Sicker?

Posted on by Brian Casey

Amid the rush of enthusiasm for CT lung cancer screening, a new study published in JAMA Health Forum offers a cautionary note. Researchers found that in the real world, people eligible for lung screening were sicker than those in research studies, and thus may not enjoy screening’s benefits to the same extent. 

Support for CT lung cancer screening is based on randomized controlled trials published in 2011 (NLST) and NELSON (2020) that showed screening reduced lung cancer mortality among high-risk individuals who typically had long smoking histories. 

  • The studies have spurred momentum for large-scale CT lung cancer screening programs, with a number of European and Asian countries starting national initiatives. 

But how generalizable are these results? Researchers noted that people who participated in the NLST study tended to be younger and healthier than individuals who qualify for screening in the real world. 

  • Co-morbidities like COPD, diabetes, and heart disease, as well as age and racial background, can have an impact on survival after treatment for lung cancer, and thus could reduce screening’s risk/benefit calculation. 

In the new Personalized Lung Cancer Screening study, researchers analyzed the comorbidity profiles of 31.8k people who got screened between 2016 and 2021 in California, Florida, and South Carolina. 

  • They noted that their PLuS study cohort was more diverse in terms of age, race, and ethnicity than that used in NLST, and potentially had more comorbid conditions. 

In analyzing their population, PLuS researchers found that compared to NLST participants, people screened in their real-world programs had …

  • Higher rates of COPD (33% vs. 18%).
  • Higher rates of diabetes (25% vs. 9.7%).
  • Higher rates of heart disease (16% vs. 13%).
  • Were more likely to be aged 70 and over (25% vs. 8.8%).
  • Had high scores on various metrics of comorbidity and frailty. 

Older, sicker patients are less likely to have good health outcomes after lung cancer surgery, and might also succumb to conditions like COPD, diabetes, and heart disease before lung cancer, which could also reduce lung screening’s benefits.

The Takeaway

While the new findings aren’t likely to seriously dampen CT lung cancer screening’s growing momentum, they do illustrate a point that should always be kept in mind when looking at research results: in the real world, your mileage may vary. 

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