Phillip M. Boiselle MD, Presenter: Nothing to Disclose

Caroline Chiles MD, Abstract Co-Author: Nothing to Disclose

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

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

To determine trends in CT lung cancer screening at leading academic medical centers.

An electronic survey was emailed in March 2014 to thoracic radiologists at 21 leading academic medical centers, identified from the 2012-2013 US News & World Report listings of top hospitals, cancer centers, and pulmonary medicine centers. Radiologists who reported that they currently offer lung cancer screening were asked additional questions which ranged from patient selection policies to the likelihood of implementing forthcoming LUNG-RADS in their practice. March 2014 survey results were compared to March 2013 survey results for select questions that overlapped between the 2 surveys.

Of the 20 survey respondents (95% response rate), 19 (95%) currently have an active CT screening program, an increase from 79% in 2013. Five or fewer patients are scanned per week at most sites (14 of 19, 74%), and only 1 site (5%) reported >20 patients per week. Regarding charges, all exams were self-pay at 9 of 19 (47%) screening sites and a majority was self-pay at the remaining sites. Similar to 2013, most programs (12 of 19, 63%) require physician referral for screening. NLST entry criteria remained the most common patient selection criteria in 2014, but 5 sites (26%) recently expanded their age criteria in response to new USPSTF recommendations. Regarding solid nodule size thresholds for defining a positive screen, 13 of 19 (68%) sites use ≥4 mm, 3 sites (16%) use ≥ 5mm, 2 sites (11%) use ≥6 mm, and 1 site (5%) does not use a size criterion. Less than half of the screening sites (9 of 19, 47%) definitely plan to incorporate LUNG-RADS. Almost all programs (18 of 19, 95%) routinely report coronary artery calcifications and most report this qualitatively (89%) rather than quantitatively (11%).

Most leading academic medical centers have CT screening programs, but relatively few patients are being screened. Only a minority of sites has modified its selection criteria in response to new USPSTF guidelines and fewer than half definitely plan to incorporate forthcoming LUNG-RADS in their practice. 

Screening programs should be encouraged to standardize their lung cancer screening practices. Forthcoming ACR-STR practice guidelines and LUNG-RADS can facilitate this process.

Boiselle, P, Chiles, C, Ravenel, J, White, C, Trends in CT Screening for Lung Cancer at Leading Academic Medical Centers.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002664.html