Barriers, Facilitators, and Suggested Interventions for Lung Cancer Screening Among a Rural Screening-Eligible Population

Introduction: Rural areas are disproportionally affected by lung cancer late-stage incidence and mortality. Lung cancer screening (LCS) is recommended to find lung cancer early and reduce mortality, yet uptake is low. The purpose of this study was to elucidate the barriers to, facilitators of, and suggested interventions for increasing LCS among a rural screening-eligible population using a mixed methods concurrent embedded design study. Methods: Qualitative and quantitative data were collected from rural-residing adults who met the eligibility criteria for LCS but who were not up-to-date with LCS recommendations. Study participants (n = 23) took part in 1 of 5 focus groups and completed a survey. Focus group discussions were recorded, transcribed, and coded through a mixed deductive and inductive approach. Survey data were used to enhance and clarify focus group results; these data were integrated in the design and during analysis, in accordance with the mixed methods concurrent embedded design approach. Results: Several key barriers to LCS were identified, including an overall lack of knowledge about LCS, not receiving information or recommendation from a health care provider, and lack of transportation. Key facilitators were receiving a provider recommendation and high motivation to know the screening results. Participants suggested that LCS uptake could be increased by addressing provider understanding and recommendation of LCS and conducting community outreach to promote LCS awareness and access. Conclusion: The results suggest that the rural screening-eligible population is generally receptive to LCS. Patient-level factors important to getting this population screened include knowledge, transportation, motivation to know their screening results, and receiving information or recommendation from a provider. Addressing these factors may be important to increase rural LCS uptake.

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Barriers to uptake among high-risk individuals declining participation in lung cancer screening: a mixed methods analysis of the UK Lung Cancer Screening (UKLS) trial

BMJ Open ◽

10.1136/bmjopen-2015-008254 ◽

2015 ◽

Vol 5 (7) ◽

pp. e008254 ◽

Cited By ~ 56

Author(s):

Noor Ali ◽

Kate J Lifford ◽

Ben Carter ◽

Fiona McRonald ◽

Ghasem Yadegarfar ◽

...

Keyword(s):

Lung Cancer ◽

Mixed Methods ◽

Cancer Screening ◽

High Risk ◽

Lung Cancer Screening ◽

The Uk

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Mobile Low-Dose Computed Tomographic (LDCT) Scanning combined with Remote Reading: a feasible approach to lung cancer screening among rural population

10.21203/rs.3.rs-430566/v1 ◽

2021 ◽

Author(s):

Bojiang Chen ◽

Jun Shao ◽

Jinghong Xian ◽

Pengwei Ren ◽

Wenxin Luo ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Rural Areas ◽

Pulmonary Nodules ◽

Lung Cancer Screening ◽

Western China ◽

Control Group ◽

Local Hospital ◽

Lung Cancers ◽

Computed Tomographic

Abstract BackgroundLow-dose computed tomographic (LDCT) screening has been proven to be powerful in detecting lung cancers in early stage. However, it’s hard to carry out in less-developed regions in lacking of facilities and professionals. The feasibility and efficacy of mobile LDCT scanning combined with remote reading by experienced radiologists from superior hospital for lung cancer screening in deprived areas was explored in this study.MethodsA prospective cohort was conducted in rural areas of western China. Residents over 40 years old were invited for lung cancer screening by mobile LDCT scanning combined with remote image reading or local hospital-based LDCT screening. Rates of positive pulmonary nodules and detected lung cancers in the baseline were compared between the two groups.ResultsAmong 8073 candidates with preliminary response, 7251 eligibilities were assigned to the mobile LDCT with remote reading (n = 4527) and local hospital-based LDCT screening (n = 2724) for lung cancer. Basic characteristics of the subjects were almost similar in the two cohorts except that the mean age of participants in mobile group was relatively older than control (61.18 vs. 59.84 years old, P < 0.001). 1778 participants with mobile LDCT scans with remote reading (39.3%) revealed 2570 pulmonary nodules or mass, and 352 subjects in the control group (13.0%) were detected 472 ones (P < 0.001). Proportions of nodules less than 8 mm or subsolid were both more frequent in the mobile LDCT group (83.3% vs. 76.1%, 32.9% vs. 29.8%, respectively; both P < 0.05). In the baseline screening, 26 cases of lung cancer were identified in the mobile LDCT scanning with remote reading cohort, with a lung cancer detection rate of 0.57% (26/4527), which was significantly higher than control (4/2724 = 0.15%, P = 0.006). Moreover, 80.8% (21/26) of lung cancer patients detected by mobile CT with remote reading were in stage I, remarkedly higher than that of 25.0% in control (1/4, P = 0.020).ConclusionMobile LDCT combined with remote reading is probably a potential mode for lung cancer screening in rural areas.Trial registrationNo. of registration trial was ChiCTR-DDD-15007586 (http://www.chictr.org).

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Second primary lung cancer in the United States: 1992–2008.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.6_suppl.309 ◽

2017 ◽

Vol 35 (6_suppl) ◽

pp. 309-309

Author(s):

Nicholas Donin ◽

Lorna Kwan ◽

Andrew T. Lenis ◽

Drakaki Alexandra ◽

Mark S. Litwin ◽

...

Keyword(s):

Lung Cancer ◽

Bladder Cancer ◽

Cancer Screening ◽

Cancer Survivors ◽

Lung Cancer Screening ◽

The United States ◽

Second Primary ◽

Incidence And Mortality ◽

Screening Trial

309 Background: Tobacco smoke is a known risk factor for both bladder and lung cancer. We hypothesized that bladder cancer survivors are at high risk for second primary lung cancers (SPLC), and sought to describe the incidence and mortality attributable to SPLC among survivors of bladder cancer as well as other common cancers in the United States. Methods: We identified adult patients diagnosed with a localized primary malignancy from 8 of the most common non-pulmonary cancer sites in Surveillance, Epidemiology, and End Results (SEER) data from 1992–2008. We explored factors associated with the incidence and mortality from SPLC using bivariable and multivariable models. Finally, we compared standardized incidence rates (SIRs) for SPLC in our cohort with the control arm of the National Lung Screening Trial (NLST), a large lung cancer screening trial in patients at high risk for lung cancer. Results: We identified 1,431,809 survivors of common non-pulmonary cancers, of whom 24,477 (1.7%) developed SPLC at a mean (SD) follow-up of 5.7 (3.6) years. Bladder cancer survivors developed SPLC at twice the rate of other cancer survivors, with 10% developing SPLC in the 20 years following their bladder cancer diagnosis. Increasing age and male gender were independent risk factors for SPLC, irrespective of the primary cancer type. Of patients who developed SPLC, 19,059 (78%) died during follow-up. Lung cancer was responsible for 73% of these deaths, such that over half (57%) of the cancer survivors who develop SPLC ultimately died of lung cancer. Bladder cancer survivors demonstrated a SIR of 512 cases/100,000 person-years, which approaches the rate (572 cases/100,000 person-years) seen in the control arm of the NLST. Conclusions: Over half of patients who develop SPLC died of their disease. Almost 10% of bladder cancer survivors develop SPLC in the 20-years following their diagnosis. This rate approaches that seen in the control arm of the NLST, suggesting that the incidence in bladder cancer survivors could justify lung cancer screening in this population. Further efforts to better define the potential risks and benefits of lung cancer screening in bladder cancer survivors is warranted.

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Terminate lung cancer (TLC) study—A mixed-methods population approach to increase lung cancer screening awareness and low-dose computed tomography in Eastern Kentucky

Cancer Epidemiology ◽

10.1016/j.canep.2016.11.003 ◽

2017 ◽

Vol 46 ◽

pp. 1-8 ◽

Cited By ~ 10

Author(s):

Roberto Cardarelli ◽

David Reese ◽

Karen L. Roper ◽

Kathryn Cardarelli ◽

Frances J. Feltner ◽

...

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

Mixed Methods ◽

Cancer Screening ◽

Low Dose ◽

Lung Cancer Screening ◽

Population Approach ◽

Eastern Kentucky ◽

Low Dose Computed Tomography

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The OncoSim Cancer Simulation Platform: A Tool to Project the Population Effects of Cancer Control Interventions in Canada

Journal of Global Oncology ◽

10.1200/jgo.18.20300 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 77s-77s

Author(s):

N. Fitzgerald ◽

C. Gauvreau ◽

S. Memon ◽

S. Hussain ◽

A. Coldman ◽

...

Keyword(s):

Lung Cancer ◽

Decision Making ◽

Cancer Screening ◽

Control Strategies ◽

Cancer Control ◽

Lung Cancer Screening ◽

Long Term Effects ◽

National Guidelines ◽

Incidence And Mortality ◽

Statistics Canada

Background: Cancer control interventions exert their effects over multiple decades. To evaluate diverse and competing opportunities to reduce future cancer burden it is desirable to understand long-term effects prior to any new program implementation or significant change. Internationally, modeling is becoming an accepted source of planning information for decision-makers. Aim: We will describe the construction and use of the OncoSim microsimulation model, which was developed to evaluate cancer control strategies in Canada. Methods: OncoSim is a suite of models (cancers of the lung, colorectum, cervix and breast, plus a composite 32-cancer model) used to address key policy questions and support decision-making. It is led by the Canadian Partnership Against Cancer with model development by Statistics Canada. OncoSim incorporates risk factors, cancer natural history, screening, treatment, survival and end-of-life care. Wherever possible it is informed by Canadian data sources. Models are calibrated to reproduce a range of cancer-specific statistics, e.g., current and historical Canadian cancer-specific incidence and mortality, smoking patterns, and results of screening. The site-specific models have undergone further validation by replicating reported short-term effects of cancer prevention and screening interventions. Users may customize interventions through modifying input parameters. Outputs include incidence, mortality, costs, cost-effectiveness, and resource utilization. Users from the public sector have access at no cost to OncoSim and receive extensive support from a multidisciplinary technical team. The model is continually updated to incorporate emerging knowledge. Results: OncoSim has been used to support cancer control decision-making at the national and provincial/territorial levels. Applications include: national guidelines recommendations for colorectal and lung cancer screening; comparison of cytology vs. HPV based cervical cancer screening; and integration of smoking cessation into low-dose CT lung cancer screening. Conclusion: Validated simulation models such as OncoSim can be a versatile and efficient tool for cancer control planners to evaluate and prioritize cancer control strategies.

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Implementation of a Web-based Tool for Shared Decision Making in Lung Cancer Screening: A Mixed Methods Quality Improvement Evaluation (Preprint)

JMIR Human Factors ◽

10.2196/32399 ◽

2021 ◽

Author(s):

Julie Lowery ◽

Angela Fagerlin ◽

Angela R. Larkin ◽

Renda S. Wiener ◽

Sarah E. Skurla ◽

...

Keyword(s):

Lung Cancer ◽

Decision Making ◽

Quality Improvement ◽

Mixed Methods ◽

Cancer Screening ◽

Shared Decision Making ◽

Lung Cancer Screening ◽

Shared Decision ◽

Web Based

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P2.11-28 A Focus Group and Interview Study to Explore the Information-Needs of Lung Cancer Screening Participants

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2018.08.1375 ◽

2018 ◽

Vol 13 (10) ◽

pp. S790

Author(s):

M. Ruparel ◽

S. Quaife ◽

D. Baldwin ◽

S. Janes ◽

J. Waller

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Focus Group ◽

Information Needs ◽

Lung Cancer Screening ◽

Interview Study

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Safety and Effectiveness of Lung Cancer Screening Using Low-dose Computed Tomography Scan in High-risk Individuals: A Comprehensive Review

Health Technology Assessment in Action ◽

10.18502/htaa.v5i2.8008 ◽

2021 ◽

Author(s):

Sara Mohamadi ◽

Rajabali Daroudi ◽

Mohamadreza Mobinizadeh

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

Cancer Screening ◽

High Risk ◽

Cancer Mortality ◽

Lung Cancer Screening ◽

Lung Cancer Mortality ◽

Comprehensive Review ◽

Incidence And Mortality ◽

Technical Specifications

Context: Lung cancer is the most important cause of cancer mortality. Given the incidence and mortality of this disease, the implementation of preventive interventions is necessary. Objectives: The present study investigated the effectiveness of one of the most important interventions of lung cancer screening with lowdose computed tomography (LDCT) in high-risk individuals. Evidence Acquisition: The present study was an applied study performed as a comprehensive review. For the assessment of safety, studies on the technical specifications of computed tomography scans and issues related to the safety of applying this device were searched using keywords in medical databases. For the evaluation of clinical effectiveness, a comprehensive review of health technology assessment studies, systematic review studies, and screening guidelines was performed. Results: Based on 15 studies extracted for the safety issue, the diagnosis of harmless tumors, false positives cases and Unnecessary invasive complementary interventions, and possible negative effects of radiation exposure are discussable safety issues. Based on the synthesis of 16 studies on effectiveness, lung cancer screening intervention using LDCT was determined to reduce lung cancer mortality by 15 - 20% and mortality from other causes by 0 - 6%. Additionally, the incidence of this disease in its upper stages decreases significantly. Conclusions: Lung cancer screening using LDCT does not threaten the health of individuals seriously and, in comparison to nonintervention is more clinically effective and will lead to a statistically significant reduction in lung cancer mortality and increase in the timely diagnosis of this disease.

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