Oatmeal Healthoatmealhealth.com · public-data estimate, October 2026

Duke University Health System

Lung screening gap across 15 counties in North Carolina and Virginia

110,000to220,000adults in its service area qualify for lung cancer screening and are not being screened

About 2,300 people here are diagnosed with lung cancer each year, and 65% are found at a late stage, when it is hardest to treat.

Explore the screening network
VANCWVSC
15 counties3 acute care hospitalsService area
140,000 to 270,000adults likely qualify under USPSTF 2021 criteria (estimate)
1,300lung cancer deaths a year in these counties, 2020 to 2024
19.2%of eligible adults screened in these states, vs 18.2% nationally

Estimates from public data only; no patient information. Sources and method below.

Where the eligible adults live

The counties where most of Duke University Health System's Medicare inpatients live. Darker areas hold more adults who likely qualify, which is where outreach would start. Hover or tap any area for its estimate.

Adults likely eligible, per neighborhood

0+180+250+300+350+420+490+

Acute care hospital in this system

Counties in the service area

CountyStateAdults likely eligibleLung cancer deaths per 100kMedicare screens billed locally, 2024
Wake CountyNorth Carolina34,700 to 80,90024.72,791
Guilford CountyNorth Carolina23,100 to 43,70032.71,285
Durham CountyNorth Carolina10,400 to 23,70025.1852
Cumberland CountyNorth Carolina13,500 to 22,90043.61,320
Johnston CountyNorth Carolina11,400 to 16,90044.380
Alamance CountyNorth Carolina8,500 to 14,50041.1None billed locally
Orange CountyNorth Carolina4,400 to 11,80021.4553
Harnett CountyNorth Carolina6,500 to 9,90047.218
Nash CountyNorth Carolina5,700 to 8,70035.5210
Chatham CountyNorth Carolina4,100 to 7,80023.4730
Franklin CountyNorth Carolina4,300 to 6,30036.7None billed locally
Pittsylvania CountyVirginia4,500 to 5,90035.4None billed locally
Granville CountyNorth Carolina3,500 to 5,70038.2None billed locally
Vance CountyNorth Carolina2,600 to 4,10043.8None billed locally
Person CountyNorth Carolina2,600 to 3,90042.9None billed locally

6 of the 15 counties had no Medicare lung screening reads billed from a local address in 2024. County names link to their Missing Millions page.

What closing the gap would mean

If screening in these counties rose from 19.2% to 24.2%, five points above today, about 7,000 to 13,300 more people would be screened each year.

In the National Lung Screening Trial, low-dose CT screening lowered lung cancer deaths by 20% compared with chest X-ray. Today about 65% of lung cancers here are found at a late stage.

Illustrative estimate: eligible adults (range) times the change in screening rate. Not a forecast or a guarantee.

Each year in these counties

2,300new lung cancers
1,500found at a late stage
1,300lung cancer deaths

NCI and CDC State Cancer Profiles, annual averages.

Screening at Duke University Health System today

Clinicians at Duke University Health System locations billed 954 low-dose CT lung screening reads to Medicare fee-for-service in 2024. Including Medicare Advantage and other insurers, we estimate about 2,300 to 6,700 screenings a year.

Most adults who qualify see a primary care clinician every year. We count 1,387 primary care clinicians, 37 pulmonologists and 11 thoracic surgeons practicing at Duke University Health System locations. A 20 pack-year smoking history is often missing from structured EHR fields, so many eligible patients are never flagged.

CMS Medicare Physician and Other Practitioners 2024 (CPT 71271); clinicians matched to Duke University Health System by practice address using the AHRQ Compendium of U.S. Health Systems 2023, so reads billed by outside radiology groups are not included. The all-payer estimate scales Medicare fee-for-service by the local Medicare Advantage share (58%, CMS) and, at the high end, by the share of eligible adults under 65 (66%).

3 acute care hospitals

  • Duke University HospitalDurham, NC
  • Duke Regional HospitalDurham, NC
  • Duke Raleigh HospitalRaleigh, NC

Find them, reach them, give radiologists a second opinion

LungIQ Find

Reads clinical notes, diagnoses and medications in the EHR and returns a ranked list of patients likely eligible, including those whose pack-year history is missing. Start with a CSV export refreshed every 1, 3 or 6 months, or connect through FHIR or HL7.

LungNAV Reach

An AI patient navigator that texts and calls patients in 70+ languages, answers questions about the scan, and hands each patient to your scheduling team or nurse navigators with a call summary.

LungAI Second opinion

Gives radiologists a malignancy risk score for each nodule, factoring in change since the prior scan, inside the PACS and CADe software they already use. The radiologist makes the final call.

LungAI is an investigational medical device and has not been cleared by FDA. It is not commercially available in the United States.

How we estimate the gap

Modeled estimates from public data. They are not a count of Duke University Health System patients and contain no patient information.

  • Service area: CMS Hospital Service Area File 2025 (counties within 120 miles of a system hospital holding 80% of its Medicare inpatients, plus any county with at least 1%); hospitals from the AHRQ Compendium of U.S. Health Systems, 2023.
  • Eligible adults, low estimate: Oatmeal Health Missing Millions (Census 2025 population, CDC PLACES smoking, USPSTF 2021).
  • Eligible adults, high estimate: University of Minnesota National Lung Cancer Screening Estimates (Haynes 2026), which also counts former smokers.
  • Screening rate: American Lung Association, State of Lung Cancer 2025.
  • Lung cancer cases and deaths: NCI and CDC State Cancer Profiles (incidence 2019 to 2023, deaths 2020 to 2024).
  • Screening volume: CMS Medicare Physician and Other Practitioners, 2024; CMS Medicare Advantage State/County Penetration, September 2026.

LungAI is an investigational medical device and has not been cleared by FDA. Oatmeal Health is preparing a 510(k) premarket notification. LungAI is not commercially available in the United States.

See Duke University Health System's own numbers

In a 30 minute review we replace these public estimates with counts from your own records and agree on what a first program would look like.

Request a private screening review