Phillip M. Boiselle MD, Presenter: Nothing to Disclose

Charles S. White MD, Abstract Co-Author: Nothing to Disclose

James G. Ravenel MD, Abstract Co-Author: Nothing to Disclose

Evidence-based guidelines recommend that lung cancer screening be conducted at academic medical centers similar to the NLST sites, but several aspects of CT screening are not addressed by clinical guidelines. Thus, our purpose was to determine current practice patterns for CT screening at leading academic medical centers.

An electronic survey was emailed in March 2013 to thoracic radiologists at 21 leading academic medical centers, which were identified from the 2012-2013 US News & World Report listings of top hospitals, cancer centers, and pulmonary medicine centers. Participants who reported that they currently offer lung cancer screening were asked additional questions about patient selection, referral requirements, self-pay charges, dose, number of patients screened, nodule management guidelines, use of CAD and volumetric analysis software, and inclusion of a smoking cessation program.

Of the 18 survey respondents (86% response rate), 15 (83%) currently have a CT screening program and 3 (17%) are planning one. Among the 15 respondents with an active screening program, almost all included a smoking cessation program (n=14, 93%) and did not employ CAD (n=13, 87%) or nodule volumetry software (n=14, 93%). Less uniformity was reported for: patient selection criteria (NLST criteria most common, n=11, 73%); required referral from a patient’s clinician (n=11, 73%); rate of self-pay charges ($300-$400 most common, n=10, 67%); choice of guidelines for nodule management (Fleischner Society guidelines most common, n=10, 67%); and estimated scan dose (1-2 mSv most common, n=7, 47%). One to 5 patients are scanned per week at 13 of the 15 sites, which is the same or fewer than 6 months ago.

Screening programs at leading academic medical centers routinely include a smoking cessation program and only infrequently employ CAD or volumetric analysis software. However, there is less uniformity in patient selection criteria, referral requirements, self-pay charges, scan dose, and choice of nodule management guidelines.

The variability in screening practices at leading academic medical centers suggests the need for formalized radiology guidelines for CT screening for lung cancer.

Boiselle, P, White, C, Ravenel, J, CT Screening for Lung Cancer: Current Practice Patterns at Leading Academic Medical Centers.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13012958.html