According to the American Lung Association’s 2025 “State of Lung Cancer” report, just 18.2% of eligible individuals are screened for lung cancer nationwide, a rate almost three times lower than colorectal and breast cancer screening rates.
Compounding this challenge, a study of more than 10,000 adults found that while 61% of patients returned for lung cancer screening after one year, that number dropped to 51% in year two.
How then, is New York City-based NYC Health + Hospitals/Bellevue achieving a 28% lung cancer screening rate with above 75% adherence?
Vivek Murthy, MD, director of interventional pulmonology and lung cancer screening program at NYC Health + Hospitals/Bellevue, spoke to Becker’s about how the program was built, what is driving results and what other systems can take away from its approach.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What specific structural or operational elements have contributed most to Bellevue’s 28% screening rate?
Dr. Vivek Murthy: The implementation of a navigator-centric model has been instrumental to Bellevue’s screening rate. Each patient undergoing lung cancer screening is paired with a nurse practitioner navigator who helps facilitate care coordination across various disciplines, including with the patient’s primary care physician. This model ensures close follow-up and increases adherence to screening.
Furthermore, close coordination with primary care providers has ensured that patients feel the program is complementary to their existing therapeutic relationship with their primary care teams. Our Population Health group has also developed a systemwide dashboard, enabling primary care providers with direct access to information on their patient panels to provide accurate targets for enrolling screen-eligible patients.
Q: National data shows a steep drop-off in annual adherence to lung cancer screening after the initial CT, making Bellevue’s adherence rate of over 75% a significant outlier. Can you describe how Bellevue addressed common barriers to ongoing screening?
VM: Common barriers to screening that have been proactively addressed within the Bellevue Lung Cancer Screening Program include logistical challenges with scheduling, navigating the patient-primary care provider relationship and insurance-related challenges.
The Bellevue program has a dedicated project manager who contacts patients when their expected scan is due and works with them to find a convenient date to be scanned.
Patients who are found to have higher risk nodules immediately have a short-interval follow-up scan and clinic visit on the same day so that there are fewer barriers related to transportation or time off from work.
Patients are significantly more likely to follow up when they feel a screening program is working closely with their primary care team, and the PCP group at Bellevue has been exceptionally collaborative. We employ a multi-level follow-up system including phone calls, letters, telegrams and automatic alerts in Epic to all providers for patients who are due for a short-interval follow-up study.
Inaccurate code entry had been a major barrier to financial authorization for scans in the past. Our NP navigators review all low-dose CT scan orders to ensure that the acceptable and accurate billing codes have been entered, and correct them when necessary to ensure that all planned CT scans actually happen in a timely manner.
Q: What real-world lessons from Bellevue’s model do you see as scalable across other safety-net or resource-limited settings?
VM: What makes Bellevue’s program unique is the ability to offer necessary lung cancer screening CTs to every New Yorker, without exception. Screening CTs are offered to patients of diverse demographics and across a wide region across New York City, regardless of their ability to pay. This is, in part, due to access to healthcare programs such as NYC Care, ensuring patients receive necessary medical interventions such as lung cancer screening.
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