Planning and Implementation of Low-dose Computed Tomography Lung Cancer Screening Programs in the United States

Rebecca Qiu, BSN, RN; Amy Copeland, MPH; Erica Sercy, MSPH; Nancy R. Porter, MS; Karen Kane McDonnell, PhD, RN, OCN; Jan Marie Eberth, PhD


Clin J Oncol Nurs. 2016;20(1):52-58. 

In This Article

Implications for Nursing and Conclusion

Oncology nurses must understand the historic background of lung cancer screening, risks and benefits, current array of practice guidelines, and implications for guideline implementation (Lehto, 2014). Regardless of risk status, anyone who is concerned about his or her risk for lung cancer deserves information that is accurate and balanced. Oncology nurses can encourage the public, patients, and families to discuss their risk of lung cancer and the value of screening with knowledgeable healthcare providers.

Oncology nurses and nurse navigators often are involved in the development and implementation of lung cancer screening programs, as evidenced by one of the nurse navigators interviewed in the current study who reported being the contact person for all LDCT screening follow-up at her institution. Their role in the multidisciplinary team, described as an essential part of quality LDCT programs by the respondents, has the potential to support the development of screening programs, monitor the quality and outcomes of those programs, and help patients interested in or undergoing lung cancer screening to handle the anxieties associated with experiencing a screening abnormality (Wells et al., 2008).

Although seeing rising numbers of LDCT lung cancer screening programs in recent years is encouraging (Eberth, Qiu, Adams, et al., 2014), the full effect of these programs may be felt only if their quality is high and use improves (American Academy of Family Physicians, 2014; Goulart & Ramsey, 2013). As stated by Goulart and Ramsey (2013), effective implementation must be accompanied by (a) a multidisciplinary team approach, (b) development and adherence to diagnostic algorithms for follow-up, (c) appropriate selection of individuals for screening, and (d) collection of longitudinal data to track patients and scans. The current study has identified additional barriers that must be addressed to improve screening demand and use and, ultimately, cause a shift in the number of lung cancer deaths.