Research Summary

Can a Direct-to-Patient Digital Health Program Improve Lung Cancer Screening Rates?

Anthony Calabro, MA

Key Highlights

  • Patients using the mPATH-Lung digital program were significantly more likely to complete screening computed tomography (24.5%) compared with controls (17.0%).
  • The digital intervention increased lung cancer screening completion outside a clinical encounter.
  • False-positive results and invasive procedures were infrequent in both groups.
  • The intervention showed modest but meaningful improvement in screening uptake.

According to recent research, screening with low-dose chest computed tomography (CT) reduces mortality from lung cancer among high-risk individuals. However, national uptake remains suboptimal, with fewer than 20% of eligible adults undergoing screening in the United States. This study evaluated whether a direct-to-patient digital intervention could increase screening completion compared with standard care enhanced by clinician notification.

In a pragmatic randomized clinical trial conducted between April 2022 and May 2023, researchers enrolled individuals aged 50 to 77 years who met Centers for Medicare & Medicaid Services criteria for lung cancer screening. Participants were identified at two academic health systems in the southeastern United States through electronic health record data. Eligible individuals were randomly assigned 1:1 to either the digital intervention (mPATH-Lung program) or to enhanced usual care.

The mPATH-Lung program included a brief decision aid and the option to request a screening appointment, all delivered digitally outside a clinic visit. In the control group, participants received information about their screening eligibility and were advised to discuss screening with their primary care clinician. The primary outcome was completion of any chest CT within 16 weeks; secondary outcomes included screening decisions, clinical and process measures, screening-related harms, and implementation metrics.

Electronic invitations were sent to 26,909 individuals with a documented smoking history, of whom 3267 completed online eligibility questions and 1333 were enrolled. Participants had a mean age of 60.7 years, and 65% were women. Most were non-Hispanic White (79%), and 17% were Black. Insurance coverage was evenly divided between commercial (47%) and public (45%) plans. The results demonstrated a significant increase in screening completion in the intervention group compared with enhanced usual care: 24.5% (164 of 669) versus 17.0% (113 of 664), corresponding to an odds ratio of 1.6 (95% CI, 1.2–2.1). False-positive results were observed in 12.7% of mPATH-Lung participants and 8.4% of controls. Invasive procedures occurred in 2.0% and 1.1% of participants, respectively, with no associated complications reported.

The investigators concluded that “compared with enhanced usual care, a direct-to-patient digital health intervention increased rates of lung cancer screening." They further emphasized the need for “future research to assess the reach and effectiveness of digital lung cancer screening interventions across diverse populations and health care settings.”

Reference
Miller DP, Snavely AC, Dharod A, et al. A direct-to-patient digital health program for lung cancer screening: a randomized clinical trial. JAMA. Published online October 20, 2025. doi:10.1001/jama.2025.17281