Implementation of the DELFI FirstLook Lung blood test achieved a 67.6% completion rate among patients who previously declined LDCT, with 93.3% of those with elevated results receiving LDCT orders.
Observational (n=404)
Does implementation of a blood-based lung cancer screening test improve screening adherence in USPSTF-eligible patients who previously declined LDCT?
Implementation of a blood-based lung cancer screening test successfully expanded screening access, particularly among patients who had previously declined or were unengaged with traditional LDCT.
Abstract Rationale Lung Cancer Screening with Low-dose computed tomography (LDCT) effectively reduces mortality through early detection, yet real-world implementation encounters substantial barriers. Patient compliance challenges and workflow complexities significantly diminish screening benefits at the population level. To address these limitations, we implemented DELFI FirstLook Lung (FLL), a blood-based screening test, as a complementary pathway. This approach was fully integrated within our electronic health record (EHR) system with established payor reimbursement, specifically targeting patients who historically resisted or remained unengaged with conventional LDCT programs. Methods Beginning October 2024, we launched a systematic initiative offering FLL to USPSTF-eligible patients who had previously declined LDCT screening. Implementation involved integrating ordering capabilities into EHR decision-support tools with automated eligibility prompts, standardized documentation templates, and protocols for subsequent LDCT scheduling when clinically indicated. We established payor partnerships for reimbursement coverage and deployed targeted outreach strategies including patient navigator support. Results Through October 2025, we processed 404 FLL orders with 273 patients completing testing (67.6% completion rate) in a diverse population with mean age 60.37 ± 6.14 years. Notably, 174 patients (63.7%) had never received LDCT screening, while 65 patients (23.8%) were over 15 months from their last LDCT, (239/273, 87.5% collectively) representing meaningful expansion of screening access. Among completed tests, 120 (29.7%) returned elevated results triggering LDCT referral protocols. Care coordination proved effective, with 112 patients (93.3%) receiving LDCT orders and 71 (63.3%) completing imaging studies.Mean turnaround time from FLL order through blood collection to result decreased from 33.1 ± 49.3 days initially to 11.79 ± 27.36 days by quarter four—a 76% reduction. Clinic-based collection initially outperformed laboratory collection, informing workflow refinements that substantially narrowed this gap.Among 71 completed LDCT scans, Lung-RADS classifications included 19 L-RADS-1 (26.7%), 39 L-RADS-2 (54.9%), 4 L-RADS-3 (5.6%), and 6 L-RADS-4 (8.5%), with 10 patients (14%) requiring active clinical follow-up. Conclusions Blood-based screening effectively complements traditional LDCT programs when properly integrated into existing care pathways. Success factors included EHR integration, payor partnerships, and optimized laboratory collection. The 93.3% LDCT referral rate and 76% workflow improvement validate this approach. Reaching 63.7% previously unscreened patients represents meaningful progress toward population-level screening objectives. Navigation efforts continue to close the gap on patient follow-through. These findings provide actionable insights for expanding lung cancer screening access through blood-based methodologies across diverse healthcare delivery models. This abstract is funded by: None
Zaidi et al. (Fri,) conducted a observational in Lung Cancer Screening (n=404). DELFI FirstLook Lung (FLL) blood-based screening test was evaluated on Test completion rate. Implementation of the DELFI FirstLook Lung blood test achieved a 67.6% completion rate among patients who previously declined LDCT, with 93.3% of those with elevated results receiving LDCT orders.