A recent multi-institutional study has demonstrated that a direct-to-patient digital health program can significantly improve lung cancer screening uptake among people at high risk. The study, led by Wake Forest University School of Medicine in collaboration with the University of North Carolina at Chapel Hill and MD Anderson Cancer Center, was published in JAMA on October 20, 2025.
Lung Cancer Screening: An Urgent Public Health Need
Lung cancer remains the leading cause of cancer-related death worldwide. Early detection through low-dose computed tomography (CT) screening has been shown to increase survival by enabling timely treatment. However, fewer than 20% of eligible Americans undergo recommended lung cancer screening annually due to barriers such as lack of awareness, confusion about screening guidelines, and limited time for shared decision-making during clinical visits.
Study Design: Testing a Digital Outreach Approach
The researchers conducted a randomized clinical trial across two large health systems in North Carolina. Over 26,000 individuals with smoking histories were invited to participate. Those qualifying for screening were randomized to either the digital health program tool called mPATH-Lung or to an enhanced usual care group.
Enhanced usual care participants were informed of their eligibility for lung cancer screening, encouraged to discuss it with their primary care physician, and shown a short lung health educational video. The mPATH-Lung program, however, delivered an educational video, a decision aid to weigh benefits and risks, and allowed patients to request a screening appointment entirely online, independent of clinic visits.
Key Findings: Digital Program Increases Screening Completion
The primary outcome was completion of a chest CT scan for lung cancer screening within 16 weeks. Results showed that 24.5% of those enrolled in the mPATH-Lung program completed the CT scan, compared with only 17% in the enhanced usual care group, representing a significant increase in screening rates.
Importantly, the digital intervention improved screening uptake across demographic and socioeconomic groups historically facing barriers to care. There were no reported complications from screening-related procedures in either group, underscoring the safety of the approach.
Implications for Early Lung Cancer Detection and Survival
Dr. David P. Miller, professor at Wake Forest University and senior author of the study, emphasized that directly reaching patients with digital tools helps overcome common obstacles to lung cancer screening. Empowering individuals with accessible information and streamlined appointment scheduling can facilitate earlier diagnoses, which is critical since early-stage lung cancer detection markedly improves survival rates.
Future Directions and Broader Application
The research team noted the need for further studies to evaluate digital lung cancer screening programs in more diverse healthcare settings and populations. They also plan to explore strategies to maintain patient engagement with digital health tools over time.
To expand access, Dr. Miller and co-investigator Dr. Ajay Dharod have launched mPATH Health, a startup from Wake Forest to commercialize and broaden the availability of the mPATH-Lung platform. This initiative aligns with Advocate Health’s model of translating academic research into scalable health system solutions.
Conclusion
This work was supported by the National Cancer Institute and other federal funding sources, including the National Center for Advancing Translational Sciences under NIH grants. The investigators and Wake Forest University Health Sciences hold ownership interest in the mPATH technology.
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