Lung cancer screening with low-dose CT scans (LDCT) can reduce lung cancer mortality but has not been widely implemented, in part because of the challenges in implementing effective shared decision making for screen-eligible persons. The multidisciplinary expert panelists have over 10 years of experience designing, testing, and implementing effective, practical decision aids and interventions to support high-quality SDM about lung cancer screening in a variety of contexts, including in clinical settings that serve diverse communities. In this symposium, panelists will review the literature and their research findings regarding the evidence-base for lung cancer screening, opportunities for improving SDM, novel digital strategies for SDM, processes for following-up abnormal screening results, patient navigation, and novel care settings for implementing SDM. The symposium will end with opportunities for questions and audience discussion.

Topics to be discussed include

Background on lung cancer and the role of screening Why is shared decision making (SDM) important?

Limitations of SDM in routine primary care visits Existing LCS decision aids

Key decisions in implementing SDM Clinical vs public health model

LCS-specific clinics vs distributed model

Who: Finding eligible persons (assessing eligibility, outreach) When: (unrelated to, before, during, or after clinical encounters) Use of novel settings (e.g. pharmacy)

Modality: paper decision aid, digital decision aid, clinical delivery (training)

Follow-up after SDM: ensuring preferences are acted upon (including follow-up of abnormal tests) Role of navigators in ensuring high performance and equity

How to best monitor and evaluate effectiveness of SDM

After covering the topics above, we will provide 10 minutes for questions and answers as well as opportunities for ongoing communication and collaboration across programs and countries.