A Comprehensive, Multidisciplinary Approach to Improving Lung Cancer Screening

Lung cancer is the leading cause of cancer-related mortality in the United States, driving a decades-long effort to develop an effective screening strategy. In 2013, the U.S. Preventive Services Task Force (USPSTF) recommended lung cancer screening (LCS) using annual low-dose computed tomography (LDCT) to screen high-risk individuals. More than a decade later, the implementation of national screening recommendations remains poor, with fewer than 1 in 5 eligible patients in the United States receiving LCS. The authors developed and implemented a comprehensive LCS program structured around a broad evidence-based approach, including (1) educational outreach to practices, (2) population health initiatives integrated into primary care, (3) a coordinated recall process to ensure follow-up for annual screening and abnormal results, and (4) a centralized program to supplement screening and provide consultative support. Patients aged 50–80 years were eligible for the LCS program based on the 2021 USPSTF guidelines. Screening rates more than doubled from 32.8% (2,825 of 8,620) in March 2022 to 71.6% (7,976 of 11,136) in June 2025 and were not statistically different by race in the April 2025 reporting period (71.5% white; 70.9% Black; P=0.79), ethnicity (71.5% non-Hispanic; 70.3% Hispanic; P=0.67), or sex (70.6% female; 72.1% male; P=0.07). On-time completion of annual LDCT scanning exceeded 94% (7,434 of 7,895) over the year ending June 2025. In 2023 and 2024, the program diagnosed 63 cases of lung cancer, of which 49 (77.8%) were diagnosed at an early stage. The program used a well-coordinated multidisciplinary LCS program built upon a common population health infrastructure operationally aligned with other cancer screening programs. The program incorporated a defined patient registry, electronic health record prompts, patient navigators, and a dedicated team focused on conducting patient outreach. Engagement of primary care clinicians and support from radiology and pulmonary consultants were essential. Overall, the authors found that a well-coordinated LCS program built on a shared population health infrastructure can elevate LCS rates to levels comparable to other established cancer screening programs, such as those for breast and colon cancer.