Harnessing Opportunity: Pilot Intervention to Improve Lung Cancer Screening for Women Undergoing Breast Screening Mammography

Background The screening mammogram could be a “teachable moment” to improve lung cancer screening (LCS) uptake. The aim of our project was to combine patient self-referral with eligibility identification by providers as a two-pronged approach to increase rates of LCS among eligible women. Methods LCS education materials were created to stimulate patient education and encourage self-referral. Chart review of patients scheduled for screening mammography was performed to identify patients who met LCS criteria. The primary outcome was rate of acceptance of targeted interventions as measured by qualitative survey material and rate of LCS uptake. Results Between August 2022 and August 2023, 116 patients were identified by providers for potential eligibility for LCS and 34 (29.3%) deemed eligible based on the United States Preventative Services Task Force (USPSTF) 2021 guidelines. 19 (56%) patients completed LCS with 3 (16%) screen-detected nodules that led to further workup. Post-implementation qualitative survey results show that 100% of participants rated their shared decision-making visit (SDMV) experience as ‘very helpful’ and 67% responded ‘very likely’ to seek simultaneous breast and LCS in the future. Informational materials were rated as 80% favorable among all respondents, however the rate of self-referral alone was 0%. The combined rates of eligible patients lost to follow up or refusal was 24%. Conclusion The self-referral aspect of the intervention demonstrated that patients are unlikely to self-refer for LCS. On the other hand, patients undergoing screening mammograms individually identified for LCS were very responsive to learning more about dual screening.