A Coordinated Approach to Implementing Low-Dose CT Lung Cancer Screening in a Rural Community Hospital

Jessica Currier, Deb Howes, Cherie Cox, Margaret Bertoldi, Kent Sharman, Bret Cook, Derek Baden, Paige E. Farris, Wesley Stoller, Jackilen Shannon

Research output: Contribution to journalArticlepeer-review


Purpose: The authors describe a rural community hospital's approach to lung cancer screening using low-dose CT (LDCT) to address the high incidence of lung cancer mortality. Methods: An implementation project was conducted, documenting planning, education, and restructuring processes to implement a lung cancer screening program using LDCT in a rural community hospital (population 64,917, Rural-Urban Continuum Code 5) located in a region with the highest lung cancer mortality in Oregon. The hospital and community partners organized the implementation project around five recommendations for an efficient and effective lung cancer screening program that accurately identifies high-risk patients, facilitates timely access to screening, provides appropriate follow-up care, and offers smoking cessation support. Results: Over a 3-year period (2018-2020), 567 LDCT scans were performed among a high-risk population. The result was a 4.8-fold increase in the number of LDCT scans from 2018 to 2019 and 54% growth from 2019 to 2020. The annual adherence rate increased from 51% in 2019 to 59.6% in 2020. Cancer was detected in 2.11% of persons scanned. Among the patients in whom lung cancer was detected, the majority of cancers (66.6%) were categorized as stage I or II. Conclusions: This rural community hospital's approach involved uniting primary care, specialty care, and community stakeholders around a single goal of improving lung cancer outcomes through early detection. The implementation strategy was intentionally organized around five recommendations for an effective and efficient lung cancer screening program and involved planning, education, and restructuring processes. Significant stakeholder involvement on three separate committees ensured that the program's design was relevant to local community contexts and patient centered. As a result, the screening program's reach and adherence increased each year of the 3-year pilot program.

Original languageEnglish (US)
Pages (from-to)757-768
Number of pages12
JournalJournal of the American College of Radiology
Issue number6
StatePublished - Jun 2022


  • Low-dose computed tomography
  • lung cancer screening
  • multifaceted implementation strategy
  • rural community hospital

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


Dive into the research topics of 'A Coordinated Approach to Implementing Low-Dose CT Lung Cancer Screening in a Rural Community Hospital'. Together they form a unique fingerprint.

Cite this