Planning and Implementation of Low-Dose Computed Tomography Lung Cancer Screening Programs in the United States.

BACKGROUND: One of the largest, most expensive randomized, controlled trials, the National Lung Screening Trial, found that annual low-dose computed tomography (LDCT) scans led to a 20% reduction in lung cancer deaths. OBJECTIVES: This study describes the characteristics and program implementation barriers experienced by LDCT screening programs in the United States. METHODS: Using a mixed-methods approach, Lung Cancer Alliance Screening Centers of Excellence were surveyed and interviewed in 2013. Representatives from 65 centers completed an electronic questionnaire, followed by in-depth interviews with 13 physicians and nurse navigators regarding their institution's screening programs. FINDINGS: Participants cited low patient demand and few physician referrals as barriers, but few centers reported needing additional staff or equipment. Those interviewed discussed the importance of a multidisciplinary team and overcoming barriers related to insurance reimbursement, costs, and physician knowledge to improve program implementation.

Computed tomography screening for lung cancer: a survey of society of thoracic radiology members.

PURPOSE: This study aimed to determine the availability, attributes, and hindrances of current and developing US lung cancer screening programs. MATERIALS AND METHODS: An electronic questionnaire was sent to the membership of the Society of Thoracic Radiology in August 2013 and remained open for 4 weeks. Of the 225 US-based members, we received 140 responses representing 82 unique health care institutions. Descriptive statistics were used to characterize the responding health care institutions' LDCT screening availability and components. RESULTS: A majority of responding institutions reported having an active LDCT screening program (65.9%). Of the responding institutions without an active program, 89.3% reported they were considering having an LDCT screening program in the future, and 35.7% (n=10) indicated the developing status of screening recommendations as a motivating factor in not offering a screening program. Forty-four percent of participating LDCT screening centers reported that their services were self-pay only, and nearly half charged a rate of $200 to $500 for screening. CONCLUSIONS: In our sample, we found that a majority of respondents were engaged in LDCT screening programs. Growth of such programs is expected in the coming years. Finalizing screening guidelines and insurance reimbursement will likely remove barriers that inhibit further growth of LDCT lung cancer screening programs.

Lung cancer screening using low-dose CT: the current national landscape.

OBJECTIVES: Although the National Lung Screening Trial (NLST) lauds the efficacy of low-dose computed tomography (LDCT) at reducing lung cancer mortality, it has not been widely used for population-based screening. By examining the availability of U.S. LDCT screening centers, and underlying rates of lung cancer incidence, mortality, and smoking prevalence, the need for additional centers may be determined. MATERIALS AND METHODS: Locations of 203 LDCT screening centers from the Lung Cancer Alliance Screening Centers of Excellence database, a list of active NLST and International Early Lung and Cardiac Action Program (I-ELCAP) screening centers, and an independently conducted survey of Society of Thoracic Radiology members were geocoded and mapped. County-level rates of lung cancer incidence, mortality, and smoking prevalence were also mapped and overlaid with the locations of the 203 LDCT screening centers. RESULTS AND CONCLUSIONS: Results showed the majority of LDCT screening centers were located in the counties with the highest quartiles of lung cancer incidence and mortality in the Northeast and East North Central states, but several high-risk states had no or few identified screening centers including Oklahoma, Nevada, Mississippi, and Arkansas. As guidelines are implemented and reimbursement for LDCT screening follows, equitable access to LDCT screening centers will become increasingly important, particularly in regions with high rates of lung cancer incidence and smoking prevalence.