http://www.accc-cancer.org/resources/LungCancer-Tools.asp


Lung Screening Programmatic Tools ACCC Member Cancer Programs have shared the following tools and resources used in their lung screening programs. These programs have received LCA Screening Center of Excellence recognition.
If your cancer program would like to share a lung screening program tool, please contact us at [url=]resources@accc-cancer.org[/url].
Sample Letters (Patients and Referring Providers)Shared by Lahey Hospital & Medical Center:

• Screening results letter to patient [screening normal]

• Screening results letter to patient [screening, return for follow-up LDCT in 1-2 months]

• Screening results letter to patient [screening, small lymph node, follow-up LDCT recommendation]

• Screening results letter to patient [screening, small lymph node, contact healthcare provider to discuss]

• Screening results letter to patient [screening, 1 or more small lung nodules, likely benign LDCT recommended follow-up date]

• Follow-up LDCT screening exam 30-day reminder letter to patient

• Follow-up LDCT screening exam letter to referring physician

• Follow-up LDCT screening exam 90-day reminder letter to patient

• Follow-up LDCT screening exam 90-day reminder letter to physician
  

The following samples were shared by Middlesex Hospital—Total Lung Care Center:

• Screening results follow-up letter to patient

• Screening results follow-up letter to referring physician
  

QuestionnairesShared by Middlesex Hospital—Total Lung Care Center:

• CT Lung Patient Risk Questionnaire
  

Shared by KentuckyOne Health:

• LDCT Questionnaire and Physician Order Form
  

Process ResourcesShared by KentuckyOne Health:

• Flowchart: LDCT Lung Cancer Screening Program Cancer Prevention Services

• Lung Cancer Screening Pack-Year Calculator

• Lung Cancer Screening Risk—Benefit Information for Patients

• Lung Cancer Screening LDCT Program Step-by-Step for PCP offices

• LDCT Lung Cancer Screening Physician Referral Criteria Guidelines

• LDCT Internal Scheduling Procedure
  

Shared by WellStar Health System:

• Lung Cancer Screening Patient Information Guide

• Lung Cancer Screening History Assessment Form

• Lung Screening Research Registry Information Sheet for Patients
  

Shared by Northwest Community Healthcare:

• LDCT Lung Cancer Screening Program Consent Form

• LDCT Lung Cancer Screening Chart Documentation
  

Marketing MaterialsShared by Middlesex Hospital—Total Lung Care Center:

• Lung Cancer Screening: Take the First Step to Find Out if You are at High Risk
  

Shared by St.JosephHealth, St. Joseph Hospital:

• Flyer for physician education dinner on Lung Cancer: Prevention, Screening and Treatment