Opportunities and Challenges in Lung Cancer Screening Implementation: A Narrative Review

The U.S. Preventive Services Task Force and the Centers for Medicare and Medicaid Services recommend lung cancer screening for high-risk current and former smokers. Developing a comprehensive lung cancer screening (LCS) requires coordinated planning from program conception through implementation and maintenance that address both pragmatic and regulatory matters. In this review article, we discuss the available evidence, guideline recommendations, and practical considerations for implementing a high-quality lung cancer screening program. Key factors include engagement of stakeholders with a particular focus on support from providers, patients and healthcare organizations, consideration of the infrastructure and program design that will best serve local needs, and implementation of mandatory components such as a data registry and smoking cessation. We also review other recommended components that contribute to maintaining a high-quality screening program such as a clinical screening coordinator, patient navigator, and tools to improve the uptake of and adherence to lung cancer screening.