{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T18:22:25Z","timestamp":1791656545901,"version":"4.3.4"},"reference-count":56,"publisher":"Wiley","issue":"24","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["K08CA279881"],"award-info":[{"award-number":["K08CA279881"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R50CA251966"],"award-info":[{"award-number":["R50CA251966"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["UM1CA221939"],"award-info":[{"award-number":["UM1CA221939"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2025,12,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>More than a decade ago, the National Lung Screening Trial led to the recommendation of low\u2010dose computed tomography (CT) for lung cancer screening (LCS). However, few studies have explored how program changes and external factors affect patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included LCS\u2010eligible individuals from Kaiser Permanente Colorado between May 1, 2014, and December 31, 2024. Rates and proportions of LCS orders, completions, adherence to recommended follow\u2010up after baseline screening, and lung cancer yield were calculated. Multivariable log\u2010binomial regression models estimated the factors associated with baseline LCS completion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 23,602 LCS\u2010eligible individuals, 13,576 (58%) received a baseline LCS order and 8621 (37% of eligible; 64% of orders) completed screening. LCS completion was more likely among Asian\/Native Hawaiian\/Pacific Islander or Black races, and individuals who formerly smoked, had a 20\u2013 to 29\u2013pack\u2010year smoking history, &gt;1 specialty care visit, a family history of lung cancer, or a greater comorbidity burden. Overall adherence to recommended follow\u2010up was 62%; patients with a Lung CT Screening Reporting and Data System (Lung\u2010RADS) score of 4B or 4X had the highest adherence at 88%. LCS yielded 424 cases of lung cancer (5% of screened), with 68% at stage I, II, or IIIA. Cumulative incidence among those with a positive Lung\u2010RADS score was 20% at 10 years. Secular changes in LCS outcomes correlated with changes to LCS navigation processes, technology, and the coronavirus disease 2019 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This evaluation of a decade of robust LCS data within a community setting highlights the need for established national quality metrics that incentivize health systems to conduct ongoing program monitoring, evaluation, and adaptation to optimize screening benefits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70211","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T15:36:48Z","timestamp":1765985808000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Examining trends in lung cancer screening over 10\u00a0years: Eligibility, participation, cancer detection, and 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Permanente Colorado  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger Y.","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy and Critical Care, Department of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahesh","family":"Maiyani","sequence":"additional","affiliation":[{"name":"Institute for Health Research Kaiser Permanente Colorado  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie S.","family":"Steiner","sequence":"additional","affiliation":[{"name":"Institute for Health Research Kaiser Permanente Colorado  Aurora Colorado 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