Lung Cancer Screening: Multidisciplinary Experts Discuss Barriers, Opportunities

At the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting, a panel of multidisciplinary experts convened to discuss non–small cell lung cancer (NSCLC).

Moderated by Balazs Halmos, MD, of the Montefiore Einstein Comprehensive Cancer Center, the roundtable featured perspectives from Jay Lee, MD, of the University of California, Los Angeles (UCLA), Mary Pasquinelli, DNP, APRN, FNP-BC, of the University of Illinois Chicago (UIC), and Momen Wahidi, MD, MBA, of Northwestern Medicine.

In the first segment of this roundtable discussion, the panel discusses the barriers and opportunities surrounding lung cancer screening, and innovative solutions to addressing challenges surrounding lung cancer screening access, adherence, and more.

View the next segment of the roundtable, titled “From Biopsy to Biomarkers: Panel Shares Insights on NSCLC Diagnostic Process.”

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Dr. Halmos: It’s such a pleasure to be here today for the Lung Cancers Today multidisciplinary roundtable. I’m Balazs Halmos, a medical oncologist from Montefiore Einstein Comprehensive Cancer Center from the Bronx, New York, and I’m joined by a fantastic team here. Let me just start with introductions. Mary?

Dr. Pasquinelli: I’m Mary Pasquinelli. I’m a nurse practitioner. I work at the University of Illinois Chicago, and I’m the director of the lung screening program. It’s great to be here.

Dr. Halmos: It’s so nice to have you. Jay?

Dr. Lee: I’m Jay Lee, UCLA Thoracic Surgery. I’m the surgical director for the thoracic oncology program. I’ve been at UCLA for about 20 years. I’m heavily involved in neoadjuvant perioperative and adjuvant targeted therapy or IO [immuno-oncology] trials. Glad to be here.

Dr. Halmos: Thank you. Fantastic. And last, but not least, my fellow-mate from a number of years ago, Momen.

Dr. Wahidi: Hello everyone. My name is Momen Wahidi. I’m an interventional pulmonologist here at Northwestern Medicine in Chicago. I direct the interventional pulmonology program for our health system. I’m also the co-director of the lung cancer screening program at Northwestern.

Dr. Halmos: We have an incredible multidisciplinary team here today, and that’s our job, to discuss how multidisciplinary teams coordinate care for patients with lung cancer. It’s more important today than ever, just given the developments in the neoadjuvant space and elsewhere. We can just start diving in.

To cure lung cancers, we must first detect them, right? Mary, first of all, congratulations, you just got selected to be a board member of IASLC [the International Association for the Study of Lung Cancer] due to your incredible efforts in terms of lung cancer screening. We as a country are not doing so well, though. Maybe 10% to 12% of the patients who are candidates for lung cancer screening are screened, and there are issues about adherence.

How could we do better as a community to be able to detect lung cancers at a higher rate in the stage where they can be cured the most?

Dr. Pasquinelli: That is a big question. There are a lot of barriers, and there are a lot of opportunities. We know that with screening, we want to catch lung cancer early. I think about adherence or barriers being patient-related, provider-related, or institution- or systems-related.

One of the big things is building a structure around this to an increase of adherence rates. At the University of Illinois, we have changed how we do things by leveraging opportunities to build capacity around our lung screening program. We have now done proactive scheduling, so no matter where the patient is, the order is placed, and the nurse navigator or the nurse coordinator reaches out to that patient. And then, we have improved our ordering to be sure that the physicians are ordering things correctly.

Then, with our patients, we know that transportation is a big barrier, so now with the grant, we are providing transportation to them. Once we have put the systems in place, with good coordination of care from that first scan through every scan, every year, we have increased our adherence rates from 40% to 90%. I think it’s largely about the systems you put in place within your program.

Dr. Halmos: It sounds like you’ve built a fantastic program. Jay, Momen, anything to add? Do you see these efforts ultimately being fruitful? Are we starting to do better?

Dr. Wahidi: I agree with Mary. I think it’s challenging to get our patients who are eligible for lung cancer screening to come to us and get screened. Part of it is that we’re asking a lot from the primary care providers who see the patients for all the potential preventive measures. Frankly, lung cancer screening is a bit complex. It’s not as straightforward as an age criteria like for colon cancer. You need to know the smoking history, you need to know the quit date for the patient, etc. I think efforts to interact with our colleagues in primary care are important.

We created a couple of things in my institution. We created lung cancer screening clinics where if the primary care provider is too busy or it’s hard for them to organize that lung cancer screening, they can just put an order for our clinic. It could be a video visit where our team members can talk to the patient and then place the order for the CT [scan] and follow up with it.

The other thing is how to find these patients, lung cancer screening-eligible patients. What we’ve done is run a search in our electronic health records (EHRs) using the following criteria: smoking status, age, and patients who have not had a chest CT scan in the last year. It’s not going to be perfect. We’re going to have some errors. It depends on an accurate smoking history in our electronic health records. But we found about 3,000 patients or so that are immediately potentially eligible, and we’re going to reach out to them via our electronic health records and educate them about the opportunity for lung cancer screening. We’re about to launch that right now.

Dr. Pasquinelli: I love that. We are launching the same campaign here at UIC.

Dr. Wahidi: Great minds think alike.

Dr. Halmos: Fantastic. Let’s hear how California minds think.

Dr. Lee: At UCLA, we’re fortunate to have Denise Aberle, MD, who is the PI [principal investigator] of the NLST [National Lung Cancer Screening] trials, so radiology is very actively involved. Radiology has clinics for lung screening programs, and we also have peripheral clinics for pulmonologists, and some thoracic surgeons do screening. We offer both centralized and peripheral clinic models.

I think this is a great opportunity where AI [artificial intelligence] could identify, through the EMR, high-risk patients and streamline [determining] who are high-risk and eligible patients for screening, but I think that access is also a barrier.

Similar to how the EMR notifies you when you’re due for your annual physical exam or vaccination, I think it would be nice to have automated systems like that to identify and alert patients that they’re due for an annual screening CT.