PROSPR: Population-based Research to Optimize the Screening Process

Lung cancer is the leading cause of cancer deaths, with the lowest 5-year relative survival rates of all cancer types. Lung cancer incidence and mortality rates are highest among Black men, though disparities are seen across racial, geographic, and socioeconomic groups. Annual lung cancer screening with low-dose computed tomography (LDCT) is recommended for high-risk adults by numerous national guidelines, but uptake of screening remains very low.

As part of the Population-based Research to Optimize the Screening Process (PROSPR) consortium, several health systems are conducting research on ways to improve the cancer screening process, with a subset looking specifically at lung cancer screening. Alongside the other members of the Lung PROSPR Research Consortium, PC3I investigators examine utilization and outcomes of lung cancer screening across diverse populations in five different community-based healthcare systems across the U.S.

The lung cancer screening process consists of multiple steps which must all be completed and coordinated in order to be effective, but implementation of these steps varies across systems. The PROSPR lung cancer screening model was developed to outline interrelated steps across the screening process and to provide a framework to improve implementation and quality of care. This framework highlights the complexities of lung cancer screening implementation in community practice and can elucidate ways in which the process can be improved. Following this model allows researchers to examine how differences across patient, provider, healthcare, and community systems ultimately impact outcomes and to identify targets for intervention.

The frameworks developed and interrelated research conducted advance scientific understanding of lung cancer screening implementation and inform future interventions to improve screening delivery beyond the participating healthcare systems.

National Cancer Institute

LOTUS: Henry Ford Health System; Kaiser Permanente Colorado; Kaiser Permanente Hawaii; Marshfield Clinic Health System