Barriers to Screening

LDCT screening is covered for eligible individuals (as defined by the USPSTF) and 15.4% of eligible West Virginians are up to date on recommended lung cancer screening. Major challenges include limited access and follow-up costs. Currently, there are 26 American College of Radiology-accredited facilities across 18 counties that can bill Medicare or Medicaid for lung cancer screening in West Virginia.  Nationally, 7% of screened individuals undergo follow-up  procedures. The average bill for screening and follow-up care was $740.06 per person, including an average $62.46 paid out of pocket by patients. Additional barriers include a fear of receiving a cancer diagnosis, time constraints, transportation challanges, and a lack of awareness of screening eligibility, recommendations and insurance coverage. 

Current Screening Efforts 

The WVU Cancer Institute Lung Cancer Screening Program provides risk assessment, patient navigation, smoking cessation counseling, and self-referrals for LDCT screening. The LUCAS Mobile Screening Program expands access by bringing LDCT screening directly to 42 rural and medically underserved communities, reducing transportation barriers with its route coordinated to stop in areas lacking lung cancer screening facilities. Financially, it operates at a net annual operating loss (nearly $400,000 combined with Bonnie’s Bus in 2024), which is subsidized by the 340B Drug Pricing Program and grants. Its clinical return on investment is measured in early detection: screening over 6,400 residents and identifying at least 87 lung cancers since 2021.

Lung Cancer Screening Legislation 

In 2026, lawmakers introduced SB 810, the Lung Cancer Prevention and Education Act. The bill proposed establishing a statewide Lung Cancer Prevention and Education Program within the Bureau for Public Health, creating a Lung Cancer Screening and Education Fund, supporting grants for education and screening programs, covering LDCT screening for eligible residents, requiring annual public education campaigns, and reporting program outcomes to the Legislature. The bill was referred to the Senate Health and Human Resources Committee but did not advance before the end of the legislative session.

Other State Models

Several states have statewide programs that may provide useful models.The Kentucky LEADS Collaborative initially used a $7 million private grant to expand provider education, patient navigation, and quality improvement. Between 2017 and 2023, annual screenings increased from 372 to nearly 3,000, while early-stage diagnoses increased by 14% and late-stage diagnoses declined by 10%. In 2022, the Kentucky General Assembly passed HB 219, establishing a Lung Cancer Screening Program and dedicated fund within the Department for Public Health. The law created an advisory committee to guide implementation and authorized state appropriations and other funding sources to support screening. Kentucky has since drawn national attention by becoming a leader in lung cancer screening participation while also having the highest lung cancer burden in the US. 

Delaware uses tobacco settlement revenue to support a broader state cancer prevention infrastructure. In 1999, the General Assembly passed SB 8 establishing the Delaware Health Fund, which directs tobacco Master Settlement Agreement revenue toward healthcare access, disease prevention, and other health priorities. State appropriations from tobacco settlement funds have supported cancer prevention and screening programs administered by the Division of Public Health. Delaware's Screening for Life Program provides free lung cancer screening for eligible uninsured and underinsured residents, while the Delaware Cancer Treatment Program can provide treatment assistance following a cancer diagnosis. In its first four years of implementation, the rate of lung cancer decreased, and 18% of treatments were for lung cancer.