title: Initial experience with a free, high-volume, low-dose CT lung cancer screening program.
abstract: The National Lung Screening Trial demonstrated a significant mortality benefit for patients at high risk for lung cancer undergoing serial low-dose CT. Currently, the National Comprehensive Cancer Network and several United States-based professional associations recommend CT Lung screening for high-risk patients. In the absence of established reimbursement, the authors modeled and implemented a free low-dose CT lung cancer screening program to provide equitable access to all eligible patients. Elements of the program reported in this article include a decentralized referral network, centralized program coordination, structured reporting, and a patient data management system. The experience and initial results observed in this clinical setting closely match the performance metrics of the National Lung Screening Trial with regard to cancer detection and incidental findings rates. To eliminate health care disparities a vigorous lobbying effort will be needed to expedite reimbursement and make CT lung screening equally available to all patients at high-risk.
authors.affiliation: Department of Radiology, Lahey Hospital & Medical Center, Burlington, Massachusetts 01805, USA.
authors.forename: Brady J
authors.initials: BJ
authors.lastname: McKee
authors.forename: Andrea B
authors.initials: AB
authors.lastname: McKee
authors.forename: Sebastian
authors.initials: S
authors.lastname: Flacke
authors.forename: Carla R
authors.initials: CR
authors.lastname: Lamb
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Hesketh
authors.forename: Christoph
authors.initials: C
authors.lastname: Wald
mesh_terms: D000368:Aged; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000458:organization & administration*; D008875:Middle Aged; D017146:Models, Organizational; D010353:Patient Education as Topic; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011320:Primary Health Care; D011829:Radiation Dosage; D011873:Radiology Information Systems; D012907:Smoking / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000191:economics; D014481:United States / Q000453:epidemiology
keywords: Lung cancer screening; NLST; National Lung Screening Trial; low-dose chest CT