Improving access to cancer screening through national telehealth-based lung and colorectal cancer screening programs.

Abstract

1549 Background: Access to routine cancer screening remains a significant barrier to early detection, especially among historically underserved populations. However, little is known about how virtual care can improve access to cancer services. Color and the American Cancer Society (ACS) collaborated to develop two community-based, telemedicine programs for national colorectal and lung cancer screening. Here we evaluate the impact of these programs in expanding access. Methods: The Colorectal Cancer (CRC) Screening Program (launched in June 2025) provides at-home fecal immunochemical tests (FIT) to eligible individuals aged 45-75 years. Kits are distributed through federally qualified health centers and other community locations. The Lung Cancer Screening Program (launched in November 2023) offers eligible individuals access to scheduling support for low-dose screening CTs based on ACS guidelines. Both programs leverage a virtual-first approach: patients provide health history information for a cancer risk assessment through an online platform where they can also access educational resources and schedule appointments with physicians to discuss cancer risk (note: screening eligibility is determined based on self-report). Care advocates provide personalized support, including step-by-step guidance on completing tests, navigating screening guidelines, and coordinating follow-up care. Results: Across both cancer screening programs (n = 548), participants were predominantly female (CRC: 62.0%; lung: 62.9%) and had similar average ages (CRC: 50.3 years, range 18-90; lung: 53.9 years, range 18-81). In the CRC screening program, 397 participants picked up or requested kits, with the highest demand in California (10.1%), Texas (9.1%), and Florida (7.1%). In total, 126 participants were eligible and activated a kit; participant ineligibility was largely due to already being up-to-date with screening (29.1%) or age (28.5%). Of the 94 completed tests, 4 (4.3%) were abnormal results. In the lung cancer screening program, 71 participants (47%) across 28 states met ACS eligibility criteria; the remaining participants were ineligible due to age (21.1%), less than 20-pack year smoking history (25.4%), no smoking history (25.4%), or a combination of age and smoking history (28.2%). A total of 17 participants (23.9%) subsequently completed a lung CT. Average time to appointment was 29 days (range 9-93), and all appointments were located within 11 miles of the participant’s preferred location. Clinically significant findings included Lung-RADS 3 or 4 nodules (29.4%, n = 5) and other incidental findings requiring follow-up care. Conclusions: These results illustrate how targeted, community-based approaches can bridge critical gaps in cancer screening by simplifying logistics, reducing costs, and providing tailored support through virtual and community-based solutions.