### Making the Decision for Screening

A shared-decision making visit must be conducted with your patient before making a referral. This includes:

- Reviewing eligibility criteria
    - [Download the lung cancer screening CT eligibility form](https://www.bmc.org/sites/default/files/2024-01/ldct_outside_referral_eligibility_form_2024.docx)
- Discussing risks and benefits of screening
    - [This PDF](https://www.bmc.org/sites/default/files/2024-01/Lung%20Nodule%20Flyer%202023.pdf "This PDF"), produced by Boston Medical Center, provides some talking points.
    - The following review article is a good reference: ["Benefits and Harms of CT Screening for Lung Cancer: A Systematic Review" JAMA. 2012; 307(22): 2418-2429.](http://www.ncbi.nlm.nih.gov/pubmed/22610500)
- Using a decision aid, such as the following:
    - [Personalized risk calculator](http://www.shouldiscreen.com/)
    - This PDF, produced and translated by Boston Medical Center, provides general information for patients who might be considering whether to undergo lung cancer screening
- Counseling on the importance of smoking cessation and maintenance of abstinence from smoking. The [Tobacco Treatment Center](/programs/tobacco-treatment-center) has more information for both patients and providers.

### Ordering a Low-Dose CT Scan

**BMC Physicians**  
To make an order for a low dose CT scan in EPIC, enter "CT Lung Screening." [This is a sample](https://www.bmc.org/media/8656/edit) of appropriate documentation to include in your office note to reflect that the clinic visit met the above criteria.

**Non-BMC Physicians**

- Complete [this form](https://www.bmc.org/sites/default/files/2023-01/220412_ldct_outside_referral_eligibility_form.pdf).
- Fax this completed form and an order for a "low dose non-contrast CT scan" to 617.414.7891, and call 617.414.9729.

### Reporting CT Scan Results

Lung cancer screening CT reports at BMC use the [American College of Radiology Lung-RADS reporting system](https://www.acr.org/-/media/ACR/Files/RADS/Lung-RADS/Lung-RADS-2022.pdf).

Once a patient has their screening results, it may be necessary to refer them to the Lung Nodule Clinic or the Tobacco Treatment Center for further evaluation and treatment. To refer to either clinic, please follow the processes below.

### Referring to the Lung Nodule Clinic

When making a referral, please provide patient's phone number (best contact number), address, primary care provider contact information, as well as a CD copy and accompanying report of any CTs or CXRs performed at another hospital.

**BMC Physicians**  
Enter a patient referral in EPIC by typing "Lung nodule" in the Meds and Orders dialogue box.

**Non-BMC Physicians**  
Please call 617-638-5864. The Lung Nodule Clinic requires reports and scans of any previous chest imaging performed outside of BMC.

### Referring to the Tobacco Treatment Center

**BMC Physicians**  
Physicians can directly enter a patient referral in EPIC to the Tobacco Treatment Center by typing "Pulmonary smoking" in the Meds and Orders dialogue box; this will take you directly to the correct referral (please note the specific instructions that apply to Medicare vs. non-Medicare patients).

**Non-BMC Physicians**  
Please call 617.638.5864.