A Nurse Practitioner-led Centralized Lung Cancer Screening Program

Published:September 22, 2022DOI:


      • Screening individuals at higher risk of developing lung cancer with a low-dose computed tomography scan (LDCT) is evidence based.
      • Lung-screening LDCT scans are underutilized.
      • Centralized screening programs may improve compliance with follow-up.
      • Delays initiating lung cancer treatment influence patient survival.


      Lung cancer is the leading cause of cancer-related deaths. Screening eligible high-risk individuals for lung cancer with a low-dose computed tomography scan is evidence based. A nurse practitioner centralized screening process was initiated to evaluate the impact on patient volume, follow-up compliance, and the length of time from diagnosis to treatment intervention. The implementation of a centralized lung cancer screening program standardization of practice resulted in a statistically significant improvement with follow-up recommendations and patient compliance compared with the established lung cancer screening process.


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        • American Cancer Society
        Key statistics for lung cancer. American Cancer Society website.
        (Updated February 14, 2022)
        • Simon S.
        Facts & figures 2020 reports largest one-year drop in cancer mortality. American Cancer Society website.
        (January 8)
        • Hanna T.P.
        • King W.D.
        • Thibodeau S.
        • et al.
        Mortality due to cancer treatment delay: systematic review and meta-analysis.
        Br Med J (Clin Res Ed). 2020; 371: m4087
        • Heiden B.T.
        • Eaton Jr., D.B.
        • Engelhardt K.E.
        • et al.
        Analysis of delayed surgical treatment and oncologic outcomes in clinical stage 1 non-small cell lung cancer.
        JAMA Netw Open. 2021; 4e2111613
        • Khorana A.A.
        • Tullio K.
        • Elson P.
        • et al.
        Time to initial cancer treatment in the United States and association with survival over time: an observational study.
        PLoS One. 2019; 14: 1-15
        • Babar L.
        • Modi P.
        • Anjum F.
        Lung Cancer Screening. StatPearls.
        (Updated December 8, 2021. Treasure Island, FL: StatPearls Publishing)
        Date: 2021
        Date accessed: March 24, 2022
        • The National Lung Screening Trial Research Team
        Reduced lung-cancer mortality with low-dose computed tomographic screening.
        N Engl J Med. 2011; 365: 395-409
        • Wood D.E.
        • Kazerooni E.A.
        • Baum S.L.
        • et al.
        Lung Cancer Screening, Version 3.2018, NCCN Clinical Practice Guidelines in Oncology.
        J Natl Compr Canc Netw. 2018; 16: 412-441
        • Centers for Medicare & Medicaid Services
        Screening for lung cancer with low dose computed tomography (LDCT).
        (February 5)
        • American Lung Association
        Can lung cancer be found early? American Lung Association website.
        (August 27)
        • Seiler N.
        • Malcarney M.B.
        • Horton K.
        • Dafflitto S.
        Coverage of clinical preventive services under the Affordable Care Act: from law to access.
        Public Health Rep. 2014; 129: 526-532
        • American Lung Association
        State Lung Cancer Screening Coverage Toolkit. American Lung Association website.
        (November 5)
        • American Lung Association
        Coverage of tobacco cessation treatments in non-compliant health plans.
        (American Lung Association website. May)
        • Jemal A.
        • Fedewa S.A.
        Lung cancer screening with low-dose computed tomography in the United States—2010 to 2015.
        JAMA Oncol. 2017; 3: 1278-1281
        • Carter-Harris L.
        • Davis L.L.
        • Rawl S.M.
        Lung cancer screening participation: developing a conceptual model to guide research.
        Res Theory Nurs Pract. 2016; 30: 333-352
        • Pham D.
        • Bhandari S.
        • Pinkston C.
        • Oechsli M.
        • Kloecker G.
        Lung cancer screening registry reveals low-dose CT screening remains heavily underutilized.
        Clin Lung Cancer. 2020; 21: e206-e211
        • Office of Disease Prevention and Health Promotion (O. D. P. H. P)
        Increase the proportion of adults who get screened for lung cancer—C-03.
        • Reid A.E.
        • Tanoue L.
        • Detterbeck F.
        • Michaud G.C.
        • McCorkle R.
        The role of the advanced practitioner in a comprehensive lung cancer screening and pulmonary nodule program.
        J Adv Pract Oncol. 2014; 5: 440-446
        • Gilbert C.R.
        • Ely R.
        • Fathi J.T.
        • et al.
        The economic impact of a nurse practitioner–directed lung cancer screening, incidental pulmonary nodule, and tobacco-cessation clinic.
        J Thorac Cardiovasc Surg. 2018; 155: 416-424
        • Strong A.
        (2018). A nurse practitioner’s experience in the development and implementation of a lung cancer screening program.
        J Adv Pract Oncol. 2018; 9: 524-529
        • Tsai E.B.
        • Chiles C.
        • Carter B.W.
        • et al.
        Incidental findings on lung cancer screening: significance and management.
        Semin Ultrasound CT MR. 2018; 39: 273-281
        • Mazzone P.J.
        • White C.S.
        • Kazerooni E.A.
        • Smith R.A.
        • Thomson C.C.
        Proposed quality metrics for lung cancer screening programs: a national lung cancer roundtable project.
        Chest. 2021; 160: 368-378
        • Bodily B.
        • Ashurst J.
        • Fredriksen J.
        • et al.
        Results of lung cancer screening in a rural setting: a retrospective cohort study.
        Cureus. 2022; 14e23299
        • Spalluto L.B.
        • Lewis J.A.
        • Samuels L.R.
        • et al.
        Association of rurality with annual repeat lung cancer screening in the Veterans Health Administration.
        J Am Coll Radiol. 2022; 19: 131-138
        • Rohatgi K.W.
        • Marx C.M.
        • Lewis-Thames M.W.
        • Liu J.
        • Colditz G.A.
        • James A.S.
        Urban–rural disparities in access to low-dose computed tomography lung cancer screening in Missouri and Illinois.
        Prevent Chron Dis. 2020; 17: E140
        • Alvidrez J.
        • Castille D.
        • Laude-Sharp M.
        • Rosario A.
        • Tabor D.
        The National Institute on Minority Health and Health Disparities Research Framework.
        Am J Public Health. 2019; 109: S16-S20
        • Triplette M.
        • Thayer J.H.
        • Pipavath S.N.
        • Crothers K.
        Poor uptake of lung cancer screening: opportunities for improvement.
        J Am Coll Radiol. 2019; 16: 446-450
        • Vidaver R.M.
        • Shershneva M.B.
        • Hetzel S.J.
        • Holden T.R.
        • Campbell T.C.
        Typical time to treatment of patients with lung cancer in a multisite, US-based study.
        J Oncol Pract. 2016; 12: e643-e653


      Anne Marie Kinsey, DNP, ANP-BC, AGACNP-BC, is affiliated with Jefferson Abington Health, Abington, PA, and can be contacted at [email protected] .


      Kathleen Shaughnessy, DNP, MBA, ACNP-BC, is affiliated with Jefferson Abington Health, Abington, PA.


      Debbie Horine, DNP, ACNS-BC, AGACNP-BC, is affiliated with Missouri State University, Springfield, MO.