Abstract Rationale In 2022 the Centers for Medicare and Medicaid Services (CMS) dropped the reimbursement requirement of registry submission for coverage of low dose chest computed tomography (LDCT) reimbursement for lung cancer screening (LCS).1 The American College of Radiology (ACR) maintains a national LCS Registry (LCSR) and designates LCS centers who certify additional quality metrics. Prior investigation of geographic LCS access has been based on ACR LCSR, but this may underestimate access to LCS.2 We report on access to LCS not reflected in ACR data in the states of Minnesota and Wisconsin. Methods Lists of registered computed tomography (CT) scanners were obtained from Minnesota and Wisconsin state departments of health. We excluded CT scanners that were registered for research, pediatric, surgical specialty, and veterinary purposes. Research team members conducted public website review of all the included imaging centers and followed up with inquiries via telephone and/or email. For sites that offered LDCT for LCS, researchers inquired about quality features recommended by the American College of Chest Physician3 and ACR 4 with appropriate healthcare personnel (CT technologists, radiology managers, or lung cancer screening program coordinators). Results In Minnesota 181 sites were included and 29 were excluded; 158 (87% of included) sites reported offering LCS, 18 sites did not offer lung cancer screening and 5 were unable to be determined. Only 51 of these sites were included in the ACR LCSR and 10 of which were ACR Designated Lung Cancer Screening Centers as of 5/17/2024. In Wisconsin 220 sites were included and 34 excluded. 142 (65% of included) sites were found to offer screening, 82 of which were recognized by ACR, 34 having achieved ACR designation as of 6/16/2025. Only 2 sites from Wisconsin reported they were not offering screening, 76 were unable to be determined. Quality metric responses are described in the included table. Conclusion In Minnesota, the majority of imaging centers, clinics and healthcare systems conducting LCS were not participating in the ACR LCSR despite conducting LCS. This was not true in Wisconsin, but it is likely this is due to a lower response rate. Sites not recognized by ACR LCSR demonstrated similar quality features to ACR LCSR participating sites with the exception of structured processes for tobacco cessation. Lung cancer screening access in Minnesota and Wisconsin is not accurately reflected by the ACR locator, but most LCS programs report meeting quality recommendations. This abstract is funded by: None
Richardson et al. (Fri,) studied this question.