UR Medicine’s primary care network has significantly increased its lung cancer screening rates, according to a recent study published in NEJM Catalyst. The network achieved a nearly 72 percent screening rate among eligible patients, compared to the national average of about 16 percent.
The study outlines strategies that contributed to this improvement. These include developing a custom algorithm within the electronic health record system to more accurately calculate smoking history and identify patients who meet screening criteria. Primary care teams at 42 practices are able to view daily lists of patients due for breast, colon, and lung cancer screenings. Additionally, alerts during patient visits serve as reminders for clinicians to discuss lung cancer screening and smoking cessation.
Robert Fortuna, MD, MPH, professor of Primary Care and Pediatrics at the University of Rochester Medical Center (URMC) and lead author of the study, said: “Our biggest success was not only screening a high percentage of eligible patients, but also enrolling those patients in the comprehensive program to ensure they receive the necessary annual follow-up screenings.”
Lung cancer screening is recommended annually for people aged 50-80 who currently smoke or have quit within the past 15 years and have at least a 20 pack-year smoking history. Identifying eligible individuals can be challenging due to changes in smoking habits over time and incomplete medical records.
M. Patricia Rivera, MD, chief of Pulmonary and Critical Care Medicine at URMC and an author of the study, noted: “There are a lot of barriers in identifying the individuals that meet this criteria. For breast cancer screening, you just need to be a woman over 40. Anyone 45 or older should get a colonoscopy. For lung cancer screening, we have to quantify the smoking history, which is very complicated as smoking habits change over time and are often poorly recorded in the medical record.”
The increase in screenings may have led to earlier detection of lung cancer cases within UR Medicine’s program. In 2023 and 2024, there were 63 diagnosed cases; nearly 78 percent were found at an early stage when treatment outcomes tend to be better.
Patients shared their experiences with regular screenings. Phyllis Semeraro from Rochester said: “I get screened every year without fail.” She explained that after a suspicious spot was detected on her lung during one scan—later found not to be cancerous—she continued with annual CT scans: “To save your life, it’s worth 10 minutes.” Another patient, Oben Cintron from Greece commented: “It got me a little nervous before I went in, but at the end of the day everything worked out and I’m glad I did it to remove any doubts.”
Fortuna emphasized that while technology played an important role in improving processes for identifying eligible patients and tracking follow-ups, collaboration among primary care providers as well as radiology/imaging and pulmonary teams was essential for success.
Lung cancer screening guidelines were first recommended nationally in 2013; since then awareness remains low compared with other types of routine cancer screenings such as mammograms or colonoscopies.
For those seeking help quitting smoking—which reduces risk factors associated with lung cancer—the Wilmot Cancer Institute Tobacco Cessation Program along with resources from New York State Quitline are available through UR Medicine.
