Early Adherence to Lung Cancer Screening.

To the Editor:

We read the article by Triplette and colleagues (1) with great interest and appreciate that the topic of early adherence to lung cancer screening (LCS) is brought to the fore with this publication. The authors’ findings share some similarities with those we reported in the European Respiratory Journal 13 years ago (2). Both studies consist of a retrospective analysis of approximately 650 participants in LCS programs. The main difference between them is that participants in our program underwent screening with low-dose computed tomography in the context of a single site at an academic center in Pamplona, Spain, whereas the study by Triplette and colleagues included individuals screened in a multisite, decentralized LCS program in Seattle, Washington. Both studies found lower than optimal adherence to screening in a real-world setting. We also found increased adherence in former versus current smokers and in those with more concerning findings on the baseline low-dose computed tomography (higher Lung-Rads in the Seattle study and larger noncalcified nodules in the study from Pamplona). In addition, we reported increased adherence associated with a nursing intervention, especially in women, and abnormal lung function in men. Distance to the screening center, female sex, and motivation for screening (encouragement by family or primary care physician) were other parameters associated with higher adherence rates in our study. We would like to stress the importance of the nursing intervention, which at our center, improved adherence dramatically. We believed then, as we do now, that a nurse coordinator is the key to maintaining adherence to LCS by contacting participants who fail to return for follow up, repeatedly if necessary. No screening program can be successful without it.