Establishing a lung cancer screening program in a non-university hospital

Lung cancer screening (LCS) with low dose CT scanning is now recommended for appropriate high-risk individuals. The initial programs for LCS were based at large university centers. A high-quality LCS program requires a multidisciplinary team approach, often easier to assemble within an academic environment. However, in order to facilitate widespread use, LCS programs must be implemented outside the university hospital setting and within local communities. Once the United States Preventative Services Task Force (USPSTF) endorsed LCS, a number of best practice recommendations and regulatory requirements have emerged. Building the proper coalition of physicians, administrators, nurses, and other staff is critical to the success of a community LCS program. In this article, we review the essential elements for establishing a community program focusing on (I) program leadership, (II) radiology infrastructure, (III) standardized workflows, reporting, and data tracking, (IV) marketing and communication, and (V) reimbursement and finance. Moreover, based on our experience in a United States mid-sized community teaching hospital, we highlight three significant challenges we faced: (I) patient point of entry, (II) specific patient eligibility, and (III) follow-up accountability. We hope this article provides a useful template for establishing a LCS program in a non-university hospital.