title: An official American Thoracic Society/American College of Chest Physicians policy statement: implementation of low-dose computed tomography lung cancer screening programs in clinical practice.
abstract: BACKGROUND
  Annual low-radiation-dose computed tomography (LDCT) screening for lung cancer has been shown to reduce lung cancer mortality among high-risk individuals and is now recommended by multiple organizations. However, LDCT screening is complex, and implementation requires careful planning to ensure benefits outweigh harms. Little guidance has been provided for sites wishing to develop and implement lung cancer screening programs.
  
  
  OBJECTIVE
  To promote successful implementation of comprehensive LDCT screening programs that are safe, effective, and sustainable.
  
  
  METHODS
  The American Thoracic Society (ATS) and American College of Chest Physicians (ACCP) convened a committee with expertise in lung cancer screening, pulmonary nodule evaluation, and implementation science. The committee reviewed the evidence from systematic reviews, clinical practice guidelines, surveys, and the experience of early-adopting LDCT screening programs and summarized potential strategies to implement LDCT screening programs successfully.
  
  
  RESULTS
  We address steps that sites should consider during the main three phases of developing an LDCT screening program: planning, implementation, and maintenance. We present multiple strategies to implement the nine core elements of comprehensive lung cancer screening programs enumerated in a recent ACCP/ATS statement, which will allow sites to select the strategy that best fits with their local context and workflow patterns. Although we do not comment on cost-effectiveness of LDCT screening, we outline the necessary costs associated with starting and sustaining a high-quality LDCT screening program.
  
  
  CONCLUSIONS
  Following the strategies delineated in this policy statement may help sites to develop comprehensive LDCT screening programs that are safe and effective.
authors.forename: Renda Soylemez
authors.initials: RS
authors.lastname: Wiener
authors.forename: Michael K
authors.initials: MK
authors.lastname: Gould
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Arenberg
authors.forename: David H
authors.initials: DH
authors.lastname: Au
authors.forename: Kathleen
authors.initials: K
authors.lastname: Fennig
authors.forename: Carla R
authors.initials: CR
authors.lastname: Lamb
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Mazzone
authors.forename: David E
authors.initials: DE
authors.lastname: Midthun
authors.forename: Maryann
authors.initials: M
authors.lastname: Napoli
authors.forename: David E
authors.initials: DE
authors.lastname: Ost
authors.forename: Charles A
authors.initials: CA
authors.lastname: Powell
authors.forename: M Patricia
authors.initials: MP
authors.lastname: Rivera
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Slatore
authors.forename: Nichole T
authors.initials: NT
authors.lastname: Tanner
authors.forename: Anil
authors.initials: A
authors.lastname: Vachani
authors.forename: Juan P
authors.initials: JP
authors.lastname: Wisnivesky
authors.forename: Sue H
authors.initials: SH
authors.lastname: Yoon
mesh_terms: D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008403:Mass Screening / Q000191:economics / Q000592:standards*; D011829:Radiation Dosage; D013902:Radiography, Thoracic / Q000592:standards; D016540:Smoking Cessation; D012955:Societies, Medical; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014481:United States