title: Planning and Implementation of Low-Dose Computed Tomography Lung Cancer Screening Programs in the United States.
abstract: 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.
  
  
  OBJECTIVE
  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.
  
  
  RESULTS
  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.
authors.affiliation: Cone Health.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Qiu
authors.affiliation: Lung Cancer Alliance.
authors.forename: Amy
authors.initials: A
authors.lastname: Copeland
authors.affiliation: University of South Carolina.
authors.forename: Erica
authors.initials: E
authors.lastname: Sercy
authors.affiliation: University of South Carolina.
authors.forename: Nancy R
authors.initials: NR
authors.lastname: Porter
authors.affiliation: School of Nursing, University of Virginia in Charlottesville.
authors.forename: Karen Kane
authors.initials: KK
authors.lastname: McDonnell
authors.affiliation: University of South Carolina.
authors.forename: Jan
authors.initials: J
authors.lastname: Eberth
mesh_terms: D055088:Early Detection of Cancer; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008403:Mass Screening / Q000458:organization & administration* / Q000706:statistics & numerical data; D011829:Radiation Dosage; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014481:United States
keywords: early detection of cancer; health services research; lung neoplasms; spiral computed tomography