Digital health program increases lung cancer screening rates in high-risk individuals

A new study led by researchers at Wake Forest University School of Medicine, in collaboration with the University of North Carolina at Chapel Hill and MD Anderson Cancer Center, has found that a direct-to-patient digital health program can significantly increase lung cancer screening rates among people at high risk. 

The findings appear online today in JAMA. 

Lung cancer is the leading cause of cancer death worldwide, but early detection through screening can improve outcomes and save lives. Despite this, less than 20% of eligible Americans are screened for lung cancer each year. Barriers include lack of awareness, confusion about guidelines and limited time for shared decision-making during doctor visits. 

Our goal was to address these barriers by testing a digital program that reaches patients directly, outside of traditional clinical encounters."

David P. Miller, M.D., professor of implementation science, Division of Public Health Sciences at Wake Forest University School of Medicine and corresponding author of the study

Researchers conducted a randomized clinical trial at two large academic health systems in North Carolina. Over 26,000 individuals with a history of smoking were invited to participate. Those eligible were randomly assigned to either the new digital health program (mPATH-Lung) or to enhanced usual care. 

The enhanced usual care group received a message letting them know they were eligible for lung cancer screening and were encouraged to talk with their primary care doctor about it. They also watched a short video about lung health. This approach provided more information and support than what patients might typically receive but did not include mPATH-Lung. 

The mPATH-Lung program included a brief educational video, a decision aid and the option to request a screening appointment, all delivered online, outside of a clinic visit. The main outcome measured was whether participants completed a chest CT scan for lung cancer screening within 16 weeks. 

Key Findings 

• 24.5% of participants using the digital program completed a screening CT scan, compared to 17% in the usual care group. 

• The program increased screening rates across all demographic and socioeconomic groups. 

• The digital approach allowed patients to learn about screening, weigh the benefits and risks, and easily request appointments. 

• There were no complications from screening-related procedures in either group 

"Our study shows that reaching patients directly with digital tools can help overcome barriers to lung cancer screening and potentially save lives," Miller said. "By empowering individuals with information and easy access to screening, we can make a real difference in early detection of lung cancer." 

According to Miller, the findings demonstrate that digital health interventions can modestly but meaningfully increase lung cancer screening rates, even among groups that have historically faced barriers to care. Early detection is crucial, as patients diagnosed at an early stage have much higher survival rates. The study's approach could be adapted to other preventive health services, helping more people benefit from life-saving screenings. 

The researchers noted that further studies are needed to test digital lung cancer screening programs in a wider range of health care settings and populations. Future research will also explore the best ways to keep patients engaged with digital health tools over time. 

To extend the impact of this work, Miller and co-investigator Ajay Dharod, M.D., associate professor of internal medicine, launched mPATH Health, a startup spun out of Wake Forest University School of Medicine, to make the program widely available and improve lung cancer screening and other preventive care needs. This effort reflects Advocate Health's academic learning health system model, which emphasizes translating research into real-world solutions that benefit as many people as possible. 

Miller, Dharod and Wake Forest University Health Sciences have ownership interest in the mPATH technology used to conduct this research. 

This research was supported by National Cancer Institute under grant R01CA237240. The project described used the Data and Design Services of the Wake Forest Clinical and Translational Science Institute, which is supported by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health (NIH), through award UM1TR004929. Additional funding was provided by the University Cancer Research Fund of the University of North Carolina at Chapel Hill Lineberger Comprehensive Cancer Center. The project also used services from the North Carolina Translational and Clinical Sciences Institute funded by NCATS through award UM1TR004406.