- By Doreen Witt
From mammography to lung CT scans: Modern IT scales cancer screening programs
Nationwide screening programs save lives—but they stand or fall with the complex technical processes that run in the background: from data collection and exchange to secure storage. With the upcoming introduction of lung cancer screening in 2026, doctors are facing challenges in providing the necessary technical infrastructure for data processing. We explain what is important – and how cloud-based solutions such as the TMD Cloud make a difference.
Why organized screening programs need specialized IT
Behind the smooth running of standardized screening programs lie considerable IT challenges.
One example is the logistical-technological complex that describes the patient pathway: invitation via a central office, information for insured persons, examination, double diagnosis, clarification, feedback - and ongoing quality assurance. This requires clean process chains and reliable data hubs that function across sectors.
At the same time, special data protection and evaluation requirements apply: screening data must be kept separate from the rest of the patient database, pseudonymized with screening IDs, and transmitted to cancer registries for program evaluation—with clear deletion and separation requirements.
For physicians and program managers, this means:
Medical screening programs are a separate, quality-assured data cycle - from the invitation to the cancer registry. To ensure that it runs smoothly, technical interoperability must be guaranteed in the background between standards such as DICOM, HL7/FHIR, and a robust authorization and logging concept.
Example: Mammography screening - a blueprint for quality and IT
The German mammography program has been running for 20 years in certified screening units under the supervision of reference centers - exemplary throughout Europe in terms of quality assurance. Double diagnosis and standardized clarification procedures are mandatory. Its effectiveness has been proven: Studies show a 20–30% reduction in breast cancer deaths among participants.
Compared to other cancer screening programs such as skin cancer, colon cancer, or cervical cancer screening, mammography screening is subject to particularly high requirements: Mandatory double reading generates additional image data and diagnostic cycles, quality assurance requires detailed key figures, and communication between the screening unit, referring physicians, and cancer registries is also significantly more complex.
The mammography program thus serves as a blueprint for what doctors can now expect in the context of lung cancer screening: mammography screening has already shown which technological standards are indispensable when screening programs are rolled out on a large scale.
Interoperability and security: The technological foundations for screening programs
A key success factor for cancer screening programs is the seamless interoperability of the IT systems involved. The data flow connects screening units, health insurance companies, family doctors, specialists, and government agencies such as cancer registries.
The cancer registries receive both identity data and clinical information. The data is pseudonymized in a trust center and then evaluated - this is the only way to obtain meaningful statistics without identifying patients.
Open standards are key to this data exchange. DICOM and FHIR in particular form the basis for a functioning screening network.
- DICOM: allows medical images and associated metadata to be stored and exchanged in a predefined format. Digital data exchange is standardized using the DLX format.
- FHIR: enables fast and secure exchange between different computer systems via application programming interfaces (APIs)
Next stress test: lung cancer screening starting in April 2026
The Joint Federal Committee G-BA has defined screening programs for the early detection of several types of cancer. In addition to mammography screening and skin cancer examinations, lung cancer screening will also be available to doctors from April 2026. This will generate additional examinations in approved radiology departments – and thus also increase data volumes and networking requirements.
Consequences for IT: Image data pipelines, diagnostic workflows, second opinions, and the exchange of information between departments such as pulmonology, tumor boards, and registries must be scalable without compromising security and compliance.
The role of modern cloud solutions in large-scale screenings
One thing is clear: without flexible and secure IT structures, screening networks quickly reach their limits. Open standards (e.g., DICOM, HL7/FHIR) and an archive (VNA) that is independent of individual software providers as a central data hub are crucial. Cloud-based approaches such as the TMD Cloud facilitate implementation - they form the basis for mapping processes in a stable, scalable, and legally compliant manner.
- Standardized, interoperable, and vendor-neutral: Image and diagnostic data must flow reliably between screening units, practices, and registries. At the core of this is a VNA that archives DICOM data in a standardized manner and uses open interfaces such as FHIR/HL7 for data communication. Different software such as PACS, RIS, and HIS systems can thus retrieve and process the data from the screening archive. A VNA that is cloud-based, such as the TMD Cloud, offers screening units even more flexibility compared to locally operated archive systems and enables easier connection without a lengthy IT project.
- Separate, compliant storage: Screening data must be clearly separated from routine practice data. In the cloud, you can set up your own data silos with permissions and audit-proof storage - just as required by the guidelines.
- Verifiable security: Certification in accordance with the ISO 27001 standard confirms a tested security management system that is C5 certification from the BSI has been mandatory for the use of cloud solutions in healthcare since 2024 – Telepaxx meets both requirements. Our customers' screening data is therefore protected according to the highest standards.
- Flexible scaling without hardware investment: Storage requirements grow as the number of locations increases and image volumes rise. Cloud solutions are easy to integrate and allow resources to be flexibly adapted to requirements – ideal for handling additional LDCT data without having to invest in hardware.
- Few IT resources required: The cloud provider is responsible for solution development, maintenance, and update management of the IT infrastructure. This reduces the workload on your IT team, allowing them to concentrate on their core tasks. If the cloud solution is operated as Software-as-a-Service (SaaS), you can reduce the effort even further: Updates run automatically, and additional units or partners can be connected quickly.
Lese-Tipp
Further reading: How cloud technology makes everyday life easier in medical networks – practical examples from the field.
Further reading: Practical experience: Image data management in radiology – a conversation between three experts
Conclusion: The cloud as the basis for medical screening programs
Screening programs have been proven to reduce mortality - studies show a 20–30% reduction in breast cancer deaths with mammography screening. To achieve similar success with lung cancer screening, clear processes and smooth data exchange between screening units, physicians, health insurance companies, and cancer registries are required.
Open standards and a vendor-neutral VNA ensure interoperability. Software-as-a-Service solutions from the cloud, such as the TMD Cloud, are particularly well suited for this purpose: C5-tested, ISO-certified, interoperable, and low-maintenance. Experience gained from established mammography screening can be scaled up to lung cancer screening, which will start in 2026. Since lung cancer is one of the most common cancers in Germany, it is hoped that this new screening program will also measurably reduce mortality.
Talk to us if you want to secure your screening program technically and organizationally.