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

Rebecca Qiu

Amy Copeland

Erica Sercy

Nancy R. Porter

Karen K. McDonnell

Jan Eberth

lung neoplasms, spiral computed tomography, early detection of cancer, health services research
CJON 2016, 20(1), 52-58. DOI: 10.1188/16.CJON.52-58

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.

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