Improving Smoking History Documentation to Facilitate Lung Cancer Screening Utilization

Abstract Objectives Lung cancer screening (LCS) is the only screening test incorporating behavioral risk factors into eligibility determination. However, collecting necessary smoking history data has been challenging, limiting screening uptake. In this study, we evaluated how a program coordinator’s detailed shared decision-making (SDM) impacted smoking data reliability. Methods Patients who underwent a baseline screening low-dose CT between July 31, 2013, and August 25, 2023, were stratified into pre- and post-intervention cohorts. The intervention was a comprehensive pre-CT smoking history assessment with SDM by an LCS program coordinator, implemented on July 31, 2017. We compared the completeness and concordance of smoking history data between clinician and patient self-report. Results Among 3795 patients, 670 (18%) were pre- and 3125 (82%) were post-intervention. Having a coordinator reduced missing smoking data (p