WINSTON-SALEM, N.C., Oct. 20, 2025 —  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,” said David P. Miller, M.D., professor of implementation science in the 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. 

Journal

JAMA

Funder

NIH/National Cancer Institute

DOI

10.1001/jama.2025.17281

A recent study published in JAMA, spearheaded by researchers at Mass General Brigham, sheds light on this issue and challenges the prevailing assumption that a lack of interest in healthcare fuels low screening rates among eligible individuals. The researchers scrutinized data from the 2022 Behavioral Risk Factor Surveillance System dataset, which is maintained by the U.S. Centers for Disease Control and Prevention. They explored patterns of healthcare utilization among 28,483 individuals between the ages of 50 and 79, all of whom were eligible for lung cancer screening due to their smoking history.

Astoundingly, while only 17-18% of this group opted for lung cancer screening, the same cohort demonstrated a much greater affinity for other forms of preventive care. Specifically, a striking 65% of those eligible for lung cancer screening also participated in breast and colorectal cancer screenings. This disparity suggests a level of engagement in preventive health services that contradicts the narrative of reluctance. The results insinuate that the issue lies not in the individuals themselves but rather in external barriers impacting their access to lung cancer screening.

First author Alexandra Potter, a dedicated researcher in the Division of Thoracic Surgery at Mass General Brigham, emphasized the importance of understanding the motivators behind these statistics. According to Potter, the data challenges the notion that eligible individuals are resistant to cancer screenings. Instead, she points towards a potentially complex interplay of factors that impede access to lung cancer screenings. Unlike breast and colorectal cancer screening, which rely mainly on age for eligibility, lung cancer screening criteria are notably intricate, factoring in both age and detailed smoking history. This complexity may confuse potential candidates, thereby impacting their willingness to pursue screening.

Beyond the maze of eligibility criteria, another dimension complicating the uptake of lung cancer screenings is accessibility. Potter’s research underscores that challenges related to accessing screening clinics could be significant barriers preventing high-risk individuals from engaging in lung cancer screening. The healthcare infrastructure currently in place may not adequately meet the needs of those at increased risk, further exacerbating the issue and marking a critical area of concern in public health.

As the researchers delved deeper into these dynamics, they concluded that many eligible individuals show a readiness to engage in preventive healthcare services, rejecting the notion that resistance is the primary culprit. Instead, they advocate for a broader awareness and understanding of lung cancer screening, emphasizing the importance of targeted interventions. Their findings present a clarion call for healthcare professionals, policymakers, and community leaders to enhance education around lung cancer screening.

In its current state, lung cancer diagnostic practices may be seen as archaic and inadequate, failing to catch up with advancements in public health strategies tailored for improving patient outcomes. Interventions should not only aim to educate but also reduce the barriers that keep high-risk individuals from the screenings they need. Collaborative community efforts could catalyze changes in awareness and accessibility, ultimately fostering an environment that better supports individuals seeking necessary healthcare services.

Conscientious steps must be taken to memorialize the importance of lung cancer screening in the national consciousness. Growing public understanding of this critical health service could drive increased participation, leading to earlier diagnoses and, consequently, improved outcomes. Researchers advocate a multifaceted approach that integrates ongoing education, simplified eligibility explanations, and improved clinic access to facilitate higher screening rates.

Additionally, the need for a comprehensive strategy that addresses both systemic barriers and individual motivations cannot be overstated. Empowering physicians to engage with individuals more meaningfully about their risks and the details surrounding lung cancer screenings could facilitate open dialogue. By fostering an atmosphere that prioritizes patient education, the hope is to enhance screening rates and, ultimately, save lives.

In summary, lung cancer screening is a vital component of cancer prevention that remains underutilized despite its proven efficacy. The recent research from Mass General Brigham paints a nuanced picture of the barriers faced by eligible populations, suggesting that low rates of participation are not merely a matter of personal choice. Addressing the complexities of eligibility criteria, clinic access, and public understanding are crucial steps in increasing screening rates among those most at risk.

Hence, as a community, it is essential for stakeholders across the spectrum of healthcare to work collaboratively. Engagement efforts that raise awareness of lung cancer screening and tailor interventions to reduce barriers could result in a significant impact on the lives of individuals at high risk of developing this deadly disease.

By acknowledging the multilevel factors that influence screening uptake, the future of lung cancer diagnosis and treatment may witness transformative changes that ultimately contribute to reduced mortality rates and improved patient outlooks in the fight against this menacing ailment.

Subject of Research: People
Article Title: Preventive Health Care Use Among Adults Eligible for Lung Cancer Screening in the US
News Publication Date: 2-Apr-2025
Web References: JAMA Article
References: 10.1001/jama.2025.2157
Image Credits: Mass General Brigham

Keywords: Lung cancer, Cancer screening, Disease prevention, Clinical research, Cancer research, Breast cancer, Colorectal cancer, Risk factors.