942. Lung Cancer Screening in at-risk patients with HIV in a Midwestern Clinic

Abstract Background Patients with HIV (PWH) have an increased risk of lung cancer compared to the general population. In 2013, the U.S. Preventive Services Task Force (USPSTF) released their lung cancer screening (LCS) guidelines for the general population. The objective of this study is to evaluate the frequency of and factors associated with LCS using computed tomography in at-risk PWH. Methods A retrospective chart review of patients 55-80 years old seen at a Midwestern HIV Clinic between July 1, 2016 to June 30, 2018 was conducted. Demographic, clinical, laboratory, and referral for LCS information were collected. Descriptive statistics and logistic regression models were used for analysis. Results We reviewed 347 patients, out of whom 91 were excluded for the following reasons: never smoked (8), deceased (38), pack history unknown (39), and prior lung cancer diagnosis (6). Mean (sd, range) for age was 61 (5.0, 55-78). A total of 256 patients were included in the analysis, out of whom 104 (41%) met the USPSTF criteria. No effect was identified for demographic information including race, ethnicity, gender, or insurance status on LCS referral. LCS referral was made for 22 out of 256 patients (9%) (13% of patients who met the USPSTF criteria and 5% of those who did not). Patients who received tobacco cessation counseling (OR 7.83, P=0.047) and with hepatitis C infection (OR 4.32, P=0.002) were more likely to receive LCS referral. Out of those who received LCS referral, 12/22 (55%) completed the referral. Patients with hepatitis C infection were more likely to complete LCS referral (OR 8, P=0.038). Conclusion Only 13% of patients who met USPSTF criteria were referred for LCS. Patients who received tobacco cessation counseling were more likely to receive a referral. Patients with hepatitis C infection were more likely to receive and complete LCS referral. Quality improvement efforts to improve rates of LCS in PWH are needed. Future prospective studies should examine the factors associated with LCS in PWH. Disclosures Sara H. Bares, MD, Gilead Sciences (Grant/Research Support)

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Personalized Intervention Program: Tobacco Treatment for Patients at Risk for Lung Cancer

The Journal of Smoking Cessation ◽

10.1017/jsc.2017.24 ◽

2017 ◽

Vol 13 (4) ◽

pp. 244-247 ◽

Cited By ~ 2

Author(s):

Krysten W. Bold ◽

Benjamin A. Toll ◽

Brenda Cartmel ◽

Bennie B. Ford ◽

Alana M. Rojewski ◽

...

Keyword(s):

Lung Cancer ◽

At Risk ◽

Smoking Cessation ◽

Cancer Screening ◽

High Risk ◽

Standard Care ◽

Tobacco Cessation ◽

Lung Cancer Screening ◽

Tobacco Treatment ◽

Patients At Risk

Background:Lung cancer screening and tobacco treatment for patients at high-risk for lung cancer may greatly reduce mortality from smoking, and there is an urgent need to improve smoking cessation therapies for this population.Aims:The purpose of this study is to test the efficacy of two separate, sequential interventions to promote tobacco cessation/reduction compared to standard care in smokers considered high-risk for lung cancer.Methods:The study will recruit 276 current smokers attending a lung cancer screening clinic or considered high-risk for lung cancer based on age and smoking history across two sites. Patients first will be randomized to either standard tobacco treatment (8 weeks of nicotine patch and five individual counselling sessions) or standard tobacco treatment plus personalized gain-framed messaging. At the 8-week visit, all patients will be re-randomized to receive biomarker feedback or no biomarker feedback. Repeated assessments during treatment will be used to evaluate changes in novel biomarkers: skin carotenoids, lung function, and plasma bilirubin that will be used for biomarker feedback. We hypothesize that personalized gain-framed messages and receiving biomarker feedback related to tobacco cessation/reduction will improve quit rates and prevent relapse compared to standard care. Primary outcomes include 7-day point-prevalence abstinence verified with expired carbon monoxide at 8 weeks and mean cigarettes per day in the past week at 6 months.Conclusions:Study findings will inform the development of novel interventions for patients at risk for lung cancer to improve smoking cessation rates.

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Implementation of Shared Decision Making for Lung Cancer Screening Among the Privately Insured Nonelderly

MDM Policy & Practice ◽

10.1177/2381468320984773 ◽

2021 ◽

Vol 6 (1) ◽

pp. 238146832098477

Author(s):

Ya-Chen Tina Shih ◽

Ying Xu ◽

Lisa M. Lowenstein ◽

Robert J. Volk

Keyword(s):

Lung Cancer ◽

Decision Making ◽

Cancer Screening ◽

Shared Decision Making ◽

Private Insurance ◽

Lung Cancer Screening ◽

Shared Decision ◽

Factors Associated ◽

Coverage Policy ◽

Privately Insured

Introduction. The Centers for Medicare & Medicaid Services requires a written order of shared decision making (SDM) visit in its coverage policy for low-dose computed tomography (LDCT) for lung cancer screening (LCS). With screening eligibility starting at age 55, private insurance plans will likely adopt this coverage policy. This study examined the implementation of SDM in the context of LCS among the privately insured. Methods. We constructed two study cohorts from MarketScan Commercial Claims and Encounters database 2016-2017: a LDCT cohort who received LDCT for LCS and an SDM cohort who had an LCS-related SDM visit. For the LDCT cohort, we examined the trend and factors associated with the receipt of SDM within 3 months prior to LDCT. For the SDM cohort, we studied the trend and factors associated with LDCT within 3 months after an SDM visit. Results. For privately insured adults aged <64, 93% (19,681/21,084) of the LDCT cohort did not have a billing claim indicating SDM, although the uptake of SDM increased from 3.1% in 1Q2016 to 8.2% in 4Q2017 ( P < 0.0001). For the SDM cohort, 46% (948/2048) did not have a claim for an LDCT for lung cancer screening in the 3 months after the SDM visit; this percentage increased from 29.5% in 1Q2016 to 61.8% in 3Q2017 ( P < 0.0001). Limitations. Findings cannot be generalized to other nonelderly adults without private insurance. Additionally, the rate of SDM identified from claims may be underreported. Conclusions. We found a growing but low uptake of SDM among privately insured individuals who underwent LDCT. The higher rate of LDCT in the SDM cohort than the rate reported in national studies emphasized the importance of patient awareness.

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OA03.02 Tobacco Cessation Among Patients Undergoing Lung Cancer Screening: Success with Repetition

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2021.08.042 ◽

2021 ◽

Vol 16 (10) ◽

pp. S852

Author(s):

A. Plank ◽

S. Reagan ◽

A. Sinha ◽

S. Yousafi ◽

M. Reiter

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Tobacco Cessation ◽

Lung Cancer Screening

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Lung Cancer Screening Eligibility and Utilization Among Transgender Patients: An Analysis of the 2017–2018 United States Behavioral Risk Factor Surveillance System Survey

Nicotine & Tobacco Research ◽

10.1093/ntr/ntaa127 ◽

2020 ◽

Vol 22 (12) ◽

pp. 2164-2169

Author(s):

Justin T Stowell ◽

Yasha Parikh ◽

Kimberly Tilson ◽

Anand K Narayan

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Surveillance System ◽

Smoking Status ◽

Lung Cancer Screening ◽

Behavioral Risk ◽

Behavioral Risk Factor ◽

Behavioral Risk Factor Surveillance ◽

Risk Factor Surveillance ◽

To Receive

Abstract Introduction Transgender and gender diverse (TGD) persons disproportionately face many health disparities including a higher risk of lung cancer. Lung cancer screening (LCS) using low-dose chest computed tomography has reduced lung cancer mortality in eligible high-risk smokers across several large trials, yet utilization of LCS remains low. TGD persons may be less likely to receive recommended cancer screening compared with cisgender populations. We sought to compare eligibility for and utilization of LCS between TGD and cisgender persons in the United States. We also examined if the utilization of LCS varied by smoking status within each gender identity group. Methods We analyzed data from the 2017 and 2018 Behavioral Risk Factor Surveillance System (BRFSS) cross-sectional survey to determine eligibility and utilization of LCS among TGD participants compared with cisgender persons. Logistical regression analysis of potentially confounding variables included age category, race/ethnicity, income, employment status, health insurance, and having a personal doctor. Results Of 37 023 weighted respondents, 0.5% were TGD. Although eligibility for LCS was statistically similar (8.8% TGD vs. 12.2% cisgender) (adjusted odds ratio = 0.81, 95% confidence interval = 0.27–2.39, p = .703), only 2.3% of TGD participants reported obtaining a LCS chest computed tomography versus 17.2% of cisgender participants (adjusted odds ratio = 0.04, 95% confidence interval = 0.01–0.59, p = .019). Smoking status showed no association with LCS utilization among gender identity groups. Conclusions TGD persons may be less likely to receive LCS despite having similar smoking status and eligibility of cisgender persons, suggesting a disparity in utilization of this preventative health service. Implications Targeted efforts to increase LCS utilization and promote smoking cessation for at-risk TGD patients may be warranted.

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MINI01.18: Integration of Tobacco Cessation in a Lung Cancer Screening Program

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2016.09.033 ◽

2016 ◽

Vol 11 (11) ◽

pp. S267-S268

Author(s):

Matthew A. Steliga ◽

Patricia L. Franklin ◽

Anna Gladfelter ◽

Mary E. Meek

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Tobacco Cessation ◽

Screening Program ◽

Lung Cancer Screening ◽

Cancer Screening Program ◽

Lung Cancer Screening Program

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FP13.01 Assessment of the Fear of COVID-19 and Its Impact on Lung Cancer Screening Participation Among the Korean General Population

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2021.08.249 ◽

2021 ◽

Vol 16 (10) ◽

pp. S968

Author(s):

L. Duong ◽

N. Lee ◽

Y. Kim ◽

Y. Kim

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

General Population ◽

Lung Cancer Screening ◽

Screening Participation ◽

Cancer Screening Participation

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Likely Uptake of a Future a Lung Cancer Screening Programme in Hodgkin Lymphoma Survivors: a Questionnaire Study

10.21203/rs.3.rs-1137564/v1 ◽

2021 ◽

Author(s):

Rachel Broadbent ◽

Christopher J. Armitage ◽

Philip Crosbie ◽

John Radford ◽

Kim Linton

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Hodgkin Lymphoma ◽

Multivariable Analysis ◽

Lung Cancer Screening ◽

Smoking History ◽

Malignant Neoplasms ◽

Heavy Smoking ◽

Factors Associated ◽

Increased Risk

Abstract Background Many Hodgkin lymphoma (HL) survivors are at increased risk of subsequent malignant neoplasms (SMN), including lung cancer, due to previous treatment for HL. Lung cancer screening (LCS) detects early-stage lung cancers in ever smokers but HL survivors without a heavy smoking history are ineligible for screening. There is a rationale to develop a targeted LCS. The aim of this study was to investigate levels of willingness to undergo LCS in HL survivors, and to identify the psycho-social factors associated with screening hesitancy. Methods A postal questionnaire was sent to 281 HL survivors registered in a long-term follow-up database and at increased risk of SMNs. Demographic, lung cancer risk factors, psycho-social and LCS belief variables were measured. Multivariable logistic regression analysis was performed to determine the factors associated with lung cancer screening hesitancy, defined as those who would ‘probably’ or ‘probably not’ participate. Results The response rate to the questionnaire was 58% (n=165). Participants were more likely to be female, older and living in a less deprived area than non-participants. Uptake (at any time) of breast and bowel cancer screening among those previously invited was 99% and 77% respectively. 159 participants were at excess risk of lung cancer. The following results refer to these 159. Around half perceived themselves to be at greater risk of lung cancer than their peers. Only 6% were eligible for lung cancer screening pilots aimed at ever smokers in the UK. 98% indicated they would probably or definitely participate in LCS were it available. Psycho-social variables associated with LCS hesitancy on multivariable analysis were male gender (OR 5.94 CI 1.64-21.44, p<0.01), living in an area with a high index of multiple deprivation (IMD) decile (deciles 6-10) (OR 8.22 CI 1.59-42.58, p<0.05) and lower levels of self-efficacy (OR 1.64 CI 1.30-2.08 p<0.01). Conclusion HL survivors responding to this survey were willing to participate in a future LCS programme but there was some hesitancy. A future LCS trial for HL survivors should consider the factors associated with screening hesitancy in in order to minimise barriers to participation.

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Factors Associated With Obtaining Lung Cancer Screening Among Persons Who Smoke

MDM Policy & Practice ◽

10.1177/23814683211067810 ◽

2021 ◽

Vol 6 (2) ◽

pp. 238146832110678

Author(s):

Kristin G. Maki ◽

Kaiping Liao ◽

Lisa M. Lowenstein ◽

M. Angeles Lopez-Olivo ◽

Robert J. Volk

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Intervention Group ◽

Secondary Analysis ◽

Lung Cancer Screening ◽

Smoking History ◽

Anticipated Regret ◽

Factors Associated ◽

Patient Decision ◽

Low Dose Computed Tomography

Background. Screening with low-dose computed tomography scans can reduce lung cancer deaths but uptake remains low. This study examines psychosocial factors associated with obtaining lung cancer screening (LCS) among individuals. Methods. This is a secondary analysis of a randomized clinical trial conducted with 13 state quitlines’ clients. Participants who met age and smoking history criteria were enrolled and followed-up for 6 months. Only participants randomized to the intervention group (a patient decision aid) were included in this analysis. A logistic regression was performed to identify determinants of obtaining LCS 6 months after the intervention. Results. There were 204 participants included in this study. Regarding individual attitudes, high and moderate levels of concern about overdiagnosis were associated with a decreased likelihood of obtaining LCS compared with lower levels of concern (high levels of concern, odds ratio [OR] 0.17, 95% confidence interval [CI] 0.04–0.65; moderate levels of concern, OR 0.15, 95% CI 0.05–0.53). In contrast, higher levels of anticipated regret about not obtaining LCS and later being diagnosed with lung cancer were associated with an increased likelihood of being screened compared with lower levels of anticipated regret (OR 5.59, 95% CI 1.72–18.10). Other potential harms related to LCS were not significant. Limitations. Follow-up may not have been long enough for all individuals who wished to be screened to complete the scan. Additionally, participants may have been more health motivated due to recruitment via tobacco quitlines. Conclusions. Anticipated regret about not obtaining screening is associated with screening behavior, whereas concern about overdiagnosis is associated with decreased likelihood of LCS. Implications. Decision support research may benefit from further examining anticipated regret in screening decisions. Additional training and information may be helpful to address concerns regarding overdiagnosis.

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