This study is an interventional study intended to assess the impact of a centralized outreach intervention that includes shared decision-making about lung cancer screening (LCS) in LCS-eligible primary care patients. The study's goal is to increase LCS rates compared to usual care and thus reduce lung cancer deaths.

The research team will select primary care practices included in areas where lung cancer mortality is high. An outreach registry of primary care patients obtaining care at participating practices who meet study eligibility criteria will be created from the electronic medical record. 500 primary care patients will be randomly selected for the Outreach Contact with Decision Counseling (OCDC) Group from this outreach registry. Patients targeted for inclusion in the study will have a scheduled primary care appointment 18-23 days after initial outreach contact.

Inclusion Criteria:

• Have an upcoming office visit with a primary care physician in one of the study practices
• Between the ages of 50 and 77 (inclusive)
• History of smoking (current or former) in the electronic medical record (EMR)

Exclusion Criteria:

• Chest CT performed in the last 10 months before study initiation according to EMR
• Diagnosis of lung cancer indicated in the problem list in the EMR
• Current cancer treatment or other qualifying diagnoses that would make outreach inappropriate (e.g., dementia, hearing disability)