World Lung Cancer Day 2026: An Executive Pathway Agenda

Screening programs cannot manage what the EHR cannot identify. Standardize the capture of smoking history, pack-year information, quit timing, prior screening, symptoms, and exclusions in structured fields, while recognizing that clinical decisions require current guidance and individual assessment. Audit missingness by clinic, payer, language, race and ethnicity, and geography. Apply the data-governance discipline described in leveraging data analytics for improved patient outcomes.

• Assign ownership for structured history completeness and correction.
• Validate registry logic against chart review before launching outreach.
• Separate eligible, potentially eligible, previously screened, declined, deferred, and diagnostic populations.

Map demand against imaging hours, geographic reach, payer requirements, transportation, language access, and shared-decision capacity. Patient reminders and clinician prompts can help, but they should connect to appointments that are actually available. AHRQ-supported work on EHR-integrated decision support shows how workflow design can improve appropriate screening activity without relying on memory alone. Explore the AHRQ Decision Precision+ implementation story.

• Measure days from identification to decision visit and from order to completed scan.
• Offer navigation before the patient encounters an authorization or transportation barrier.
• Pair screening access with evidence-based tobacco-treatment referral where appropriate.

An abnormal scan is not an outcome. It is the beginning of a time-sensitive coordination process that may include comparison imaging, surveillance, specialty evaluation, diagnostic testing, and multidisciplinary review. Build one work queue with named ownership, escalation rules, and backup coverage. Track open findings by acuity and elapsed time, not only by department. This same enterprise discipline should extend the organization’s broader cancer control strategy.

• Define which team owns each result from release through documented resolution.
• Escalate unreachable patients and care transitions through a standard pathway.
• Audit incidental pulmonary nodules discovered outside the screening program.

Screening and diagnostic averages can conceal meaningful gaps. Stratify the pathway by site, rurality, payer, race and ethnicity, language, disability, and other locally relevant dimensions. Combine quantitative results with patient and community feedback about stigma, fear, transportation, trust, and cost uncertainty. The goal is not a separate equity campaign. It is the operational practice described in our brief on operationalizing health equity.

• Compare outreach, completion, follow-up, and resolution rates across groups.
• Fund community health workers and navigators where barriers concentrate.
• Use plain-language materials that distinguish screening from diagnostic evaluation.

Cigarette smoking remains the leading risk factor, but lung cancer also occurs among people who never smoked. CDC estimates that 10% to 20% of U.S. lung cancers occur in people who never smoked or smoked fewer than 100 cigarettes in their lifetime. Radon, secondhand smoke, and occupational exposures also matter. Leaders should align tobacco treatment, environmental health, primary care, oncology, palliative care, and survivorship without stigmatizing patients. Our Radon Awareness Month leadership brief offers a complementary environmental-health lens.

• Train staff to use nonjudgmental language across the pathway.
• Integrate symptom escalation and diagnostic routes outside screening eligibility.
• Coordinate survivorship, behavioral health, financial navigation, and serious-illness support.