title: Initial Outcomes of a Lung Cancer Screening Program in an Integrated Community Health System.
abstract: OBJECTIVE
  Lung cancer screening with low-dose CT (LDCT) demonstrated reduced mortality in the National Lung Screening Trial, yet there is debate as to whether the reported efficacy can translate into comparable effectiveness with community-based screening. The authors' purpose is to report the baseline patient characteristics and malignancy rate in the first 18 months after implementing a lung cancer screening program in an integrated community health system.
  
  
  METHODS
  Patients were screened at 1 of 10 participating community-based centers within a 22-hospital system from 2013 to 2015. LDCT examinations were interpreted by 1 of 20 radiologists using structured reporting and an internally developed tracking system. Manual chart review was performed to ascertain the malignancy detection rate.
  
  
  RESULTS
  A total of 357 patients were screened with LDCT. Of these, 80 patients were ineligible and 3 declined enrollment. The remaining 274 patients satisfied accepted screening criteria and were enrolled in the program. Malignancy was detected in a total of 11 enrollees (4.0%), 8 with lung cancer and 3 with extrapulmonary primary malignancies. Three patients (1.1%) were diagnosed with early-stage lung cancer and received definitive therapy.
  
  
  CONCLUSIONS
  Early-stage lung cancer was detected with LDCT screening in an integrated community health system at a rate similar to other trials.
authors.affiliation: Department of Internal Medicine, Intermountain Medical Center, Murray, Utah.
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Miller
authors.affiliation: Division of Oncology, Intermountain Medical Center, Murray, Utah.
authors.forename: Patricia
authors.initials: P
authors.lastname: Kruger
authors.affiliation: Department of Radiology, Intermountain Medical Center, Murray, Utah.
authors.forename: Karen
authors.initials: K
authors.lastname: Conner
authors.affiliation: Clinical Information Systems, Intermountain Medical Center, Murray, Utah.
authors.forename: Teresa
authors.initials: T
authors.lastname: Robertson
authors.affiliation: Clinical Information Systems, Intermountain Medical Center, Murray, Utah.
authors.forename: Braden
authors.initials: B
authors.lastname: Rowley
authors.affiliation: Division of Radiation Oncology, Intermountain Medical Center, Murray, Utah.
authors.forename: William
authors.initials: W
authors.lastname: Sause
authors.affiliation: Division of Oncology, Intermountain Medical Center, Murray, Utah; Synergy Cancer Center, Las Vegas, Nevada.
authors.forename: John C
authors.initials: JC
authors.lastname: Ruckdeschel
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Intermountain Medical Center, Murray, Utah; Division of Pulmonary and Critical Care Medicine, University of Utah, Salt Lake City, Utah. Electronic address: denitza.blagev@imail.org.
authors.forename: Denitza P
authors.initials: DP
authors.lastname: Blagev
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009096:Multi-Institutional Systems; D058996:Quality Improvement; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014589:Utah / Q000453:epidemiology
keywords: LDCT; Lung cancer screening; low-dose CT; lung cancer; lung nodules; pulmonary nodules