Researchers have created a roadmap to improve national lung cancer screening rates that doubled lung cancer screening rates through their multidisciplinary lung cancer screening program, according to a study published in NEJM Catalyst.
“Our biggest success was not only screening a high percentage of eligible patients, but also enrolling those patients in the comprehensive program to ensure they receive the necessary annual follow-up screenings,” stated lead study author Robert Fortuna, MD, MPH, Professor of Primary Care and Pediatrics at the University of Rochester Medical Center (URMC).
Rationale and Study Methods
Although recommendations from the U.S. Preventive Services Task Force (USPSTF) for annual low-dose computed tomography (CT) screenings for lung cancer in high-risk individuals has been in place for more than a decade, fewer than one in five eligible patients are receiving recommended lung cancer screenings. Currently, programs for breast and colon cancer see greater screening rates than that of lung cancer.
Researchers created a comprehensive, well-coordinated lung cancer screening program that was built on a shared population health infrastructure and aligned with other cancer screening programs. The program included educational outreach to practices, population health initiatives that were integrated with primary care, coordinated recall processes for annual screening follow-up and abnormal result discussions, and a centralized program to support the screenings and consultations.
Screenings in the program aligned with the 2021 USPSTF guidelines, including patients aged 50 to 80 years who smoke or who have quit smoking within 15 years with a lifetime equivalent of 20 pack-years.
“There are a lot of barriers in identifying the individuals that meet this criteria,” said study author M. Patricia Rivera, MD, Chief of Pulmonary and Critical Care Medicine at URMC. “For breast cancer screening, you just need to be a woman over 40. Anyone 45 or older should get a colonoscopy. For lung cancer screening, we have to quantify the smoking history, which is very complicated as smoking habits change over time and are often poorly recorded in the medical record.”
Key Study Findings
Screening rates rose from 32.8% in March 2022 to 71.6% in June 2025. Screening rates were not statistically different according to race (71.5% White vs 70.9% Black; P = .79), ethnicity (71.5% non-Hispanic vs 70.3% Hispanic; P = .67), or sex (70.6% female vs 72.1% male; P = .07).
Annual lung cancer screenings on time exceeded 94% for a year time point ending in June 2025.
Sixty-three cases of lung cancer were diagnosed in 2023 and 2024 through the program, 77.8% of which were diagnosed at an early stage.
“Aligning our lung cancer screening program with our broader population health initiatives allowed us to leverage familiar workflows and broadened our reach. Throughout the country, health systems are pursuing similar goals and most have some sort of population health structure in place,” said Dr. Fortuna, who credited collaboration with the radiology, primary care, and pulmonary teams for the success of the program. “My hope is that by sharing our success, others will be able to adopt and build upon what we’re doing to screen more patients and save more lives nationwide.”
Disclosure: For full disclosures of the study authors, visit catalyst.nejm.org.
