RSNA2023 Leading Through Change
Daily Bulletin

The Benefits of Simultaneous Mammography and Lung Cancer Screenings Reminders

Monday, Nov. 27, 2023

By Mary Henderson

Sunday afternoon, Kim Lori Sandler, MD, delivered the results of the Coordinate A Lung Screening with Mammography (CALM) study, which successfully improved lung screening enrollment among women undergoing screening mammography.



"Lung cancer remains the leading cause of cancer-related mortality in women, greater than breast and ovarian cancer combined," said Dr. Sandler, associate professor of radiology and co-director of the Lung Screening program at Vanderbilt University Medical Center, Nashville, TN. "Fewer than eight percent of adults are aware that lung cancer is the number one cancer killer of women."

Despite being available and recommended by the USPSTF for 10 years, lung cancer screening uptake remains low. Fewer than 10% of eligible individuals in the U.S. have enrolled in a lung cancer screening program, compared to approximately 70% of women who undergo screening mammography.

"I noticed that women were coming in with lung cancer diagnoses that met screening criteria," Dr. Sandler said. "Very few, if any, had actually been screened with low-dose CT, even though they had decades worth of mammograms. We started thinking, 'Are we missing an opportunity to talk to women about lung health at the time of mammography?'"

After a preliminary study on 250 women that revealed five lung cancer deaths among women who qualified for, but never participated in lung cancer screening despite receiving annual mammograms, she was able to launch the CALM study.

"Lung cancer is a women's health crisis and it's time that we start to pay attention to lung screening the same way we pay attention to mammography," she said.

Study Demonstrated Targeted Outreach Effective

The CALM study was aimed at women scheduled for mammography between November 2019 to December 2022 at two geographically unique academic hospitals, who also met the eligibility criteria for lung cancer screening.

A total of 32,165 mammography participants were identified using EMRs, natural language processing and patient surveys. Based on USPSTF recommendations, 1,569 of those women were eligible for lung cancer screening. Of those women, 1,089, or 69% had not previously enrolled in such a screening.

To measure the efficacy of synchronous screening interventions, the researchers reached out to patients and their providers to let them know they could enroll in both lung and mammography screenings at the same time.

According to Dr. Sandler, the targeted outreach to patients and providers resulted in improved enrollment in lung cancer screening at both sites.

"Lung cancer screening saves lives through the early detection of disease," she said. "Improving lung screening rates in women is especially important because the mortality benefit of the screening is greater for women than men."

She said she hopes the state of Tennessee's 'Pink and Pearl' campaign, tying breast and lung screening together, will go national with the help of a customizable brochure available at the ACR website.

"It's not enough to talk about the low numbers of lung cancer screening rates," she said. "We as radiologists have an opportunity to change those by combining lung screening with mammography and other cancer screening efforts."

Access the presentation, "Successful Improvement in Lung Screening Enrollment for Women Undergoing Breast Screening - The CALM Study (Coordinate A Lung screening with Mammography)," (S4-SSCH02-1) on demand at