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Cancer. 2016 May 1;122(9):1338-42. doi: 10.1002/cncr.29937. Epub 2016 Feb 29.

Using lessons from breast, cervical, and colorectal cancer screening to inform the development of lung cancer screening programs.

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Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts.
Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.
Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland.
Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.


Multiple advisory groups now recommend that high-risk smokers be screened for lung cancer by low-dose computed tomography. Given that the development of lung cancer screening programs will face many of the same issues that have challenged other cancer screening programs, the National Cancer Institute-funded Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) consortium was used to identify lessons learned from the implementation of breast, cervical, and colorectal cancer screening that should inform the introduction of lung cancer screening. These lessons include the importance of developing systems for identifying and recruiting eligible individuals in primary care, ensuring that screening centers are qualified and performance is monitored, creating clear communication standards for reporting screening results to referring physicians and patients, ensuring follow-up is available for individuals with abnormal test results, avoiding overscreening, remembering primary prevention, and leveraging advances in cancer genetics and immunology. Overall, this experience emphasizes that effective cancer screening is a multistep activity that requires robust strategies to initiate, report, follow up, and track each step as well as a dynamic and ongoing oversight process to revise current screening practices as new evidence regarding screening is created, new screening technologies are developed, new biological markers are identified, and new approaches to health care delivery are disseminated. Cancer 2016;122:1338-1342.


implementation; lung cancer; primary care; quality; screening

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