Digital Health Programme Boosts Lung Cancer Screening Uptake in High-Risk Individuals
Key Takeaways:
- A digital health intervention (mPATH-Lung) increased lung cancer screening rates by over 40% compared with usual care.
- The programme helped people overcome common barriers to screening, including lack of awareness and limited clinical consultation time.
- Findings demonstrate the potential of direct-to-patient digital tools to improve early cancer detection and preventive care.
Digital tools for early detection
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 shown that a direct-to-patient digital health programme can significantly increase lung cancer screening rates among people at high risk.
The findings were published in JAMA and mark an important step towards using digital health to support early cancer detection.
Lung cancer remains the leading cause of cancer-related death worldwide. However, early detection through low-dose computed tomography (CT) screening can dramatically improve outcomes and survival rates. Despite this, fewer than 20% of eligible individuals in the United States currently undergo lung cancer screening each year.
Common barriers include a lack of awareness, confusion over screening eligibility guidelines, and limited opportunities for shared decision-making within standard clinical appointments.
“Our goal was to address these barriers by testing a digital programme 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.
How the study worked
The randomised clinical trial was conducted across two major academic health systems in North Carolina. More than 26,000 individuals with a history of smoking were invited to take part. Those who met the screening eligibility criteria were randomly assigned to one of two groups: the mPATH-Lung digital health programme or enhanced usual care.
The enhanced usual care group received a message informing them that they were eligible for lung cancer screening and were encouraged to speak with their primary care clinician. They also viewed a short educational video on lung health. Although this provided more support than standard practice, it did not include access to the mPATH-Lung platform.
By contrast, participants in the mPATH-Lung group received access to a fully digital intervention comprising:
- A brief educational video,
- A structured decision aid outlining the benefits and risks of screening, and
- An option to request a screening appointment directly online.
This approach allowed participants to learn at their own pace and make informed decisions without needing an in-person consultation.
The main outcome measured was the completion of a low-dose CT scan for lung cancer screening within 16 weeks of enrolment.
Results and key findings
The results demonstrated a clear improvement in screening uptake.
- 24.5% of participants who used the mPATH-Lung programme completed a screening CT scan, compared with 17% of those in the enhanced usual care group.
- The increase in screening rates was consistent across demographic and socioeconomic groups, suggesting that the digital approach may help reduce health disparities.
- There were no reported 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,” said Miller. “By empowering individuals with information and easy access to screening, we can make a real difference in early detection of lung cancer.”
Implications for preventive health
According to Miller, the findings highlight that digital health interventions can modestly but meaningfully improve screening uptake, even among populations that have historically faced barriers to preventive care. Early detection is crucial, as individuals diagnosed at an early stage of lung cancer have significantly higher survival rates.
The research team believes that the mPATH-Lung approach could be adapted to other preventive health services, enabling more people to benefit from life-saving interventions such as cancer screenings, vaccinations, and chronic disease management programmes.
Next steps and future research
The researchers emphasised that further studies are needed to evaluate digital lung cancer screening initiatives across a broader range of healthcare settings and populations. They also plan to explore strategies for maintaining patient engagement with digital health tools over time.
To extend the impact of their work, Miller and Ajay Dharod, M.D., Associate Professor of Internal Medicine at Wake Forest University School of Medicine, have co-founded mPATH Health – a startup designed to make the programme widely available. The venture aims to expand access to lung cancer screening and other forms of preventive care, aligning with Advocate Health’s academic learning health system model, which focuses on translating research into real-world, scalable solutions.
Miller, Dharod, and Wake Forest University Health Sciences hold ownership interests in the mPATH technology used in the research.
Funding and acknowledgements
This research was supported by the National Cancer Institute under grant R01CA237240. The project utilised the Data and Design Services of the Wake Forest Clinical and Translational Science Institute, supported by the National Center for Advancing Translational Sciences (NCATS) 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 benefited from services provided by the North Carolina Translational and Clinical Sciences Institute, funded by NCATS through award UM1TR004406.
