Unlocking Better Outcomes: A Comprehensive Guide to Boosting Lung Cancer Screening Rates in Health Systems

Lung cancer screening is an important health tool, yet only 16% of those who qualify in the U.S. actually get screened. A new study published in NEJM Catalyst highlights how a primary care network in Rochester, New York, increased its screening rate to nearly 72%.

“Our biggest success was not just screening many patients but also enrolling them in a program for annual follow-ups,”

— Robert Fortuna, MD, lead author and professor at the University of Rochester Medical Center.

In January 2022, Fortuna’s team launched a program to identify patients who fit the complex criteria for lung cancer screening. With this initiative, they more than doubled their screening rate, going from 33% in March 2022 to 72% by June 2025.

This impressive increase may have led to earlier cancer diagnoses. Between 2023 and 2024, 63 cases of lung cancer were identified, with nearly 78% detected at an early stage when treatment is usually more effective.

Despite its benefits, lung cancer screening faces challenges. It was first recommended in 2013, so public awareness remains low. Complicated criteria make it hard to identify eligible individuals. Currently, guidelines suggest annual low-dose CT scans for people aged 50 to 80 who smoke or have quit within the last 15 years and have a smoking history of at least 20 pack-years (which is around one pack a day for 20 years).

Dr. M. Patricia Rivera, a principal investigator in the study, says finding eligible patients is often tough. Unlike breast or colon cancer screenings, determining criteria for lung cancer requires complex smoking history calculations. Smoking habits can change over time, adding to the difficulty.

The team developed a custom algorithm in their electronic health records. This tool helps quantify smoking history and identify eligible patients. Primary care teams can easily see which patients need screenings each day and get alerts during visits.

Technology is essential, but Fortuna emphasizes that collaboration is key. By connecting primary care, radiology, and pulmonary teams, they improved communication and streamlined the patient experience. This cooperative effort allowed existing health systems to guide patients through their screenings and ensure they returned for annual check-ups.

Fortuna hopes sharing their success encourages other health systems to adopt similar strategies. According to a recent survey by the CDC, only 2.2% of the U.S. population, aged 50 or older, participated in lung cancer screening in 2020. Efforts like Fortuna’s aim to change that and save more lives.

For more information, you can visit the University of Rochester Medical Center and the study’s reference in NEJM Catalyst here.

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Cancer, Lung Cancer, Catalyst, Health Care, Health Systems, Medicine, Pediatrics, Primary Care, Research, Smoking