WINSTON-SALEM, N.C., Oct. 20, 2025 — A groundbreaking study led by Wake Forest University School of Medicine, in collaboration with the University of North Carolina at Chapel Hill and MD Anderson Cancer Center, reveals that a direct-to-patient digital health initiative significantly enhances lung cancer screening rates among high-risk individuals. The findings, published today in JAMA, underscore the potential of digital tools in overcoming traditional healthcare barriers.
Lung cancer remains the leading cause of cancer-related deaths globally, yet early detection through screening can drastically improve survival rates. Despite this, less than 20% of eligible Americans undergo lung cancer screening annually. Contributing factors include a lack of awareness, confusion over guidelines, and limited time for shared decision-making during medical consultations.
“Our goal was to address these barriers by testing a digital program that reaches patients directly, outside of traditional clinical encounters,” stated Dr. David P. Miller, professor of implementation science at Wake Forest University School of Medicine and the study’s corresponding author.
Innovative Approach to Screening
The research team conducted a randomized clinical trial within two major academic health systems in North Carolina. Over 26,000 individuals with a history of smoking were invited to participate. Eligible participants were randomly assigned to either the new digital health program, mPATH-Lung, or to enhanced usual care.
The enhanced usual care group received a notification of their eligibility for lung cancer screening and were encouraged to discuss it with their primary care provider. They also viewed a brief video on lung health, providing more information than typically offered, yet lacking the mPATH-Lung’s comprehensive approach.
The mPATH-Lung program offered a concise educational video, a decision aid, and the option to request a screening appointment, all accessible online without the need for a clinic visit. The primary outcome measured was the completion of a chest CT scan for lung cancer screening within 16 weeks.
Key Findings and Implications
The study’s results were striking:
- 24.5% of participants using the digital program completed a screening CT scan, compared to 17% in the usual care group.
- The program increased screening rates across all demographic and socioeconomic groups.
- There were no complications from screening-related procedures in either group.
“Our study shows that reaching patients directly with digital tools can help overcome barriers to lung cancer screening and potentially save lives,” Miller emphasized. “By empowering individuals with information and easy access to screening, we can make a real difference in early detection of lung cancer.”
According to Miller, the findings suggest that digital health interventions can modestly but meaningfully increase lung cancer screening rates, even among groups historically facing barriers to care. Early detection is crucial, as patients diagnosed at an early stage have significantly higher survival rates. The study’s approach could be adapted to other preventive health services, broadening the impact of life-saving screenings.
Future Directions and Broader Impact
The researchers highlighted the need for further studies to test digital lung cancer screening programs across a wider range of healthcare settings and populations. Future research will also explore optimal strategies for maintaining patient engagement with digital health tools over time.
To expand the impact of their work, Miller and co-investigator Dr. Ajay Dharod, associate professor of internal medicine, have launched mPATH Health, a startup originating from Wake Forest University School of Medicine. This initiative aims to make the program widely available, enhancing lung cancer screening and other preventive care needs. This effort aligns with Advocate Health’s academic learning health system model, which focuses on translating research into practical solutions that benefit as many people as possible.
Miller, Dharod, and Wake Forest University Health Sciences hold ownership interests in the mPATH technology used in this research.
This research received support from the National Cancer Institute under grant R01CA237240. The project utilized the Data and Design Services of the Wake Forest Clinical and Translational Science Institute, supported by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health (NIH), through award UM1TR004929. Additional funding was provided by the University Cancer Research Fund of the University of North Carolina at Chapel Hill Lineberger Comprehensive Cancer Center. The project also used services from the North Carolina Translational and Clinical Sciences Institute funded by NCATS through award UM1TR004406.
