title: Translating New Lung Cancer Screening Guidelines into Practice: The Experience of One Community Hospital.
abstract: BACKGROUND
  In December 2013 the US Preventive Services Task Force issued a recommendation for lung cancer screening with annual low-dose computed tomography (LDCT). As screening guidelines emerge and change, this creates an environment for studying the translation of these guidelines into practice. This study assessed how these guidelines were implemented in a community hospital setting and the resulting radiologic findings.
  
  
  METHODS
  This observational study examined the radiologic outcomes of LDCT lung cancer screening guidelines and the resulting notification.
  
  
  RESULTS
  During the first year after publication of the guidelines, 94 screening LDCT scans were ordered. Of these, 21 (22.3%) did not meet the criteria outlined by the US Preventive Services Task Force. Among the 72 cases that did met published criteria, 65.3% of scans detected nodules, and among the remaining 35.6%, half had another clinically significant finding.
  
  
  CONCLUSIONS
  This study shows that new lung cancer screening guidelines, as implemented at a community hospital, resulted in radiologic findings that required follow-up in more than half of patients. Clinicians must be aware of these potential incidental findings when talking to patients about the decision to order screenings.
authors.affiliation: From the Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD (CJWL); the National Capital Consortium Family Medicine Residency Program, Fort Belvoir Community Hospital, Fort Belvoir, VA (BLG, JLW, PDS); and the Department of Family and Community Medicine, Dwight D. Eisenhower Army Medical Center, Augusta, GA (DAS). christian.ledford@usuhs.edu.
authors.forename: Christy J W
authors.initials: CJ
authors.lastname: Ledford
authors.affiliation: From the Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD (CJWL); the National Capital Consortium Family Medicine Residency Program, Fort Belvoir Community Hospital, Fort Belvoir, VA (BLG, JLW, PDS); and the Department of Family and Community Medicine, Dwight D. Eisenhower Army Medical Center, Augusta, GA (DAS).
authors.forename: Breanna L
authors.initials: BL
authors.lastname: Gawrys
authors.affiliation: From the Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD (CJWL); the National Capital Consortium Family Medicine Residency Program, Fort Belvoir Community Hospital, Fort Belvoir, VA (BLG, JLW, PDS); and the Department of Family and Community Medicine, Dwight D. Eisenhower Army Medical Center, Augusta, GA (DAS).
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Wall
authors.affiliation: From the Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD (CJWL); the National Capital Consortium Family Medicine Residency Program, Fort Belvoir Community Hospital, Fort Belvoir, VA (BLG, JLW, PDS); and the Department of Family and Community Medicine, Dwight D. Eisenhower Army Medical Center, Augusta, GA (DAS).
authors.forename: Patrick D
authors.initials: PD
authors.lastname: Saas
authors.affiliation: From the Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD (CJWL); the National Capital Consortium Family Medicine Residency Program, Fort Belvoir Community Hospital, Fort Belvoir, VA (BLG, JLW, PDS); and the Department of Family and Community Medicine, Dwight D. Eisenhower Army Medical Center, Augusta, GA (DAS).
authors.forename: Dean A
authors.initials: DA
authors.lastname: Seehusen
mesh_terms: D055088:Early Detection of Cancer / Q000379:methods / Q000592:standards*; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006764:Hospitals, Community / Q000458:organization & administration; D006801:Humans; D033162:Incidental Findings; D008168:Lung / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000517:prevention & control; D008403:Mass Screening / Q000379:methods / Q000458:organization & administration / Q000592:standards*; D019982:Organizational Case Studies; D017410:Practice Guidelines as Topic; D014057:Tomography, X-Ray Computed; D014481:United States
keywords: Cancer Screening; Decision Making; Lung Cancer; Patient-centered Care