Socio-demographic variations in lung cancer screening before and after USPSTF recommendation: Results from national health interview surveys (NHIS).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 1563-1563
Author(s):  
Qian Wang ◽  
Changchuan Jiang ◽  
Lei Deng ◽  
Yaning Zhang ◽  
Gabriel Albert Sara
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
High Risk ◽  
Household Income ◽  
Lung Cancer Screening ◽  
Population Based ◽  
Smoking History ◽  
Screening Rate ◽  
The Past ◽  
Before And After

1563 Background: In 2013, USPSTF recommended low-dose CT screening (LCS) for lung cancer in high-risk adults. The change in real-world practice is largely unknown, as well as the association with socio-demographic factors. Methods: Data were extracted from the population-based 2010 and 2015 NHIS. LCS was defined as a chest CT to check for lung cancer within the past year. We included adults aged 55 to 80 years who 1) have 30+ pack-year smoking history; 2) are currently smokers or have quitted within the past 15 years. We excluded adults who 1) have lung cancer; 2) had not seen a physician in the past year. We used weighted analyses to estimate national lung cancer screening rates. Results: A total of 874 and 1041 high-risk smokers responded to the LCS questions for lung cancer in 2010 and 2015, respectively. The screening rate more than doubled from 4.1% to 9.1% (P < 0.01) in all respondents. The increase was greater in women (2.9% to 9.5%, p < 0.01) than men (5.2% to 8.8%, p = 0.03) and in age 65-80 (4.7% to 12.3%, p < 0.01) than age 55-64 (3.8% to 6.3%, p = 0.16). White saw the largest increase and highest rate in 2015 (4.0% to 9.3%, p = < 0.01). Those with some college or above education had the highest rate in 2010, but the lowest in 2015. Household income above 75,000 dollars was associated with the lowest rate in both 2010 and 2015. Conclusions: Since the recommendation of USPSTF, LCS rate for lung cancer has doubled but remains less than 10%. Higher education and household income are associated with lower screening rate, in contrast to studies of other cancers. [Table: see text]

scholarly journals Development, validation, and evaluation of prediction models to identify individuals at high risk of lung cancer for screening in the English primary care population using the QResearch database: research protocol and statistical analysis plan

2022 ◽  
Author(s):  
Weiqi Liao ◽  
Judith Burchardt ◽  
Carol Coupland ◽  
Fergus Gleeson ◽  
Julia Hippisley-Cox ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Primary Care ◽  
Cancer Screening ◽  
High Risk ◽  
Prediction Models ◽  
Lung Cancer Screening ◽  
Population Based ◽  
Primary Care Population ◽  
Asymptomatic Patients ◽  
Diagnosis Of Lung Cancer

Background and research aim: Lung cancer is a research priority in the UK. Early diagnosis of lung cancer can improve patients' survival outcomes. The DART-QResearch project is part of a larger academic-industrial collaborative initiative, using big data and artificial intelligence to improve patient outcomes with thoracic diseases. There are two general research aims in the DART-QResearch project: (1) to understand the natural history of lung cancer, (2) to develop, validate, and evaluate risk prediction models to select patients at high risk for lung cancer screening. Methods: This population-based cohort study uses the QResearch database (version 45) and includes patients aged between 25 and 84 years old and without a diagnosis of lung cancer at cohort entry (study period: 1 January 2005 to 31 December 2020). The team conducted a literature review (with additional clinical input) to inform the inclusion of variables for data extraction from the QResearch database. The following statistical techniques will be used for different research objectives, including descriptive statistics, multi-level modelling, multiple imputation for missing data, fractional polynomials to explore non-linear relationships between continuous variables and the outcome, and Cox regression for the prediction model. We will update our QCancer (lung, 10-year risk) algorithm, and compare it with the other two mainstream models (LLP and PLCOM2012) for lung cancer screening using the same dataset. We will evaluate the discrimination, calibration, and clinical usefulness of the prediction models, and recommend the best one for lung cancer screening for the English primary care population. Discussion: The DART-QResearch project focuses on both symptomatic presentation and asymptomatic patients in the lung cancer care pathway. A better understanding of the patterns, trajectories, and phenotypes of symptomatic presentation may help GPs consider lung cancer earlier. Screening asymptomatic patients at high risk is another route to achieve earlier diagnosis of lung cancer. The strengths of this study include using large-scale representative population-based clinical data, robust methodology, and a transparent research process. This project has great potential to contribute to the national cancer strategic plan and yields substantial public and societal benefits through earlier diagnosis of lung cancer.

Implementing physician education to increase lung cancer screening compliance.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18282-e18282
Author(s):  
Coral Olazagasti ◽  
Devi Sampat ◽  
Adam Rothman ◽  
Nagashree Seetharamu ◽  
David Steiger
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
High Risk ◽  
Lung Cancer Screening ◽  
Physician Education ◽  
Smoking History ◽  
Post Intervention ◽  
Screening Criteria ◽  
Screening Guidelines ◽  
Internal Medicine Clinic

e18282 Background: Lung cancer is the leading cause of cancer-related deaths worldwide. The USPSTF recommends annual low-dose CT chest (LDCT) for lung cancer screening in adults who meet the appropriate criteria: age 55-80, current smokers or former smokers who quit within 15years, with a 30 pack-year smoking history. Even with these recommendations, screening rates in these patients remain low. We created a study to assess compliance in an outpatient Internal Medicine clinic to assess the barriers for obtaining LDCT. We hypothesized that by providing an educational program, overall compliance would increase. Methods: The study was divided in two arms: a pre-intervention arm and a post-intervention assessment. Initially, 35 physicians completed a questionnaire on their attitudes to LDCT screening and their reasons for not screening high risk patients. We created a lung cancer screening education program, which consisted of lectures provided to physicians. Following the lectures, consecutive patient visits were reviewed to assess compliance with screening. Results: In the first arm, 678 visits were reviewed. 115 patients met USPSTF criteria of whom only 26% underwent screening with LDCT. The most common reasons for not ordering LDCT scans in patients meeting criteria included: poor knowledge of criteria (22%), failure to determine if patients qualified (13%), patient refusal (8%). Following the education, 208 patients out of the 955 visits reviewed met USPSTF criteria, of which 78% underwent LDCT. Our study showed how after education, physicians were ten times more likely to screen patients for lung cancer (Odds ratio 9.98, 95% CI 5.87-16.94, p < 0.0001). Conclusions: We confirmed there was suboptimal adherence to established LDCT lung cancer screening guidelines, mainly due to unfamiliarity with the screening criteria. By providing educational lectures, compliance improved significantly. We concluded that educating physicians about lung cancer screening guidelines increased LDCT screening tenfold, and therefore benefit patients that are at high risk for developing lung cancer.

scholarly journals Attitudes towards Lung Cancer Screening in an Australian High-Risk Population

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Alexandra E. Flynn ◽  
Matthew J. Peters ◽  
Lucy C. Morgan
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
High Risk ◽  
Perceived Risk ◽  
Screening Test ◽  
Screening Program ◽  
Lung Cancer Screening ◽  
Smoking History ◽  
High Risk Population ◽  
Cancer Screening Test

Objectives. To determine whether persons at high risk of lung cancer would participate in lung cancer screening test if available in Australia and to elicit general attitudes towards cancer screening and factors that might affect participation in a screening program. Methods. We developed a 20-item written questionnaire, based on two published telephone interview scripts, addressing attitudes towards cancer screening, perceived risk of lung cancer, and willingness to be screened for lung cancer and to undertake surgery if lung cancer were detected. The questionnaire was given to 102 current and former smokers attending the respiratory clinic and pulmonary rehabilitation programmes. Results. We gained 90 eligible responses (M:F, 69:21). Mean [SD] age was 63 [11] and smoking history was 32 [21] pack years. 95% of subjects would participate in a lung cancer screening test, and 91% of these would consider surgery if lung cancer was detected. 44% of subjects considered that they were at risk of lung cancer. This was lower in ex-smokers than in current smokers. Conclusions. There is high willingness for lung cancer screening and surgical treatment. There is underrecognition of risk among ex-smokers. This misperception could be a barrier to a successful screening or case-finding programme in Australia.

scholarly journals Low Provider Knowledge Is Associated With Less Evidence-Based Lung Cancer Screening

2019 ◽  
Vol 17 (4) ◽  
pp. 339-346 ◽  
Author(s):  
Jennifer A. Lewis ◽  
Heidi Chen ◽  
Kathryn E. Weaver ◽  
Lucy B. Spalluto ◽  
Kim L. Sandler ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Lung Cancer Screening ◽  
System Level ◽  
Smoking History ◽  
Secondary Outcome ◽  
Evidence Based ◽  
The Past ◽  
High Knowledge ◽  
Provider Knowledge

Background: Despite widespread recommendation and supportive policies, screening with low-dose CT (LDCT) is incompletely implemented in the US healthcare system. Low provider knowledge of the lung cancer screening (LCS) guidelines represents a potential barrier to implementation. Therefore, we tested the hypothesis that low provider knowledge of guidelines is associated with less provider-reported screening with LDCT. Patients and Methods: A cross-sectional survey was performed in a large academic medical center and affiliated Veterans Health Administration in the Mid-South United States that comprises hospital and community-based practices. Participants included general medicine providers and specialists who treat patients aged >50 years. The primary exposure was LCS guideline knowledge (US Preventive Services Task Force/Centers for Medicare & Medicaid Services). High knowledge was defined as identifying 3 major screening eligibility criteria (55 years as initial age of screening eligibility, smoking status as current or former smoker, and smoking history of ≥30 pack-years), and low knowledge was defined as not identifying these 3 criteria. The primary outcome was self-reported LDCT order/referral within the past year, and the secondary outcome was screening chest radiograph. Multivariable logistic regression evaluated the adjusted odds ratio (aOR) of screening by knowledge. Results: Of 625 providers recruited, 407 (65%) responded, and 378 (60.5%) were analyzed. Overall, 233 providers (62%) demonstrated low LCS knowledge, and 224 (59%) reported ordering/referring for LDCT. The aOR of ordering/referring LDCT was less among providers with low knowledge (0.41; 95% CI, 0.24–0.71) than among those with high knowledge. More providers with low knowledge reported ordering screening chest radiographs (aOR, 2.7; 95% CI, 1.4–5.0) within the past year. Conclusions: Referring provider knowledge of LCS guidelines is low and directly proportional to the ordering rate for LDCT in an at-risk US population. Strategies to advance evidence-based LCS should incorporate provider education and system-level interventions to address gaps in provider knowledge.

Extent of implementation of low-dose CT in lung cancer screening.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19177-e19177
Author(s):  
Merin Jose ◽  
Rajesh Desai
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
High Risk ◽  
Low Dose ◽  
Lung Cancer Screening ◽  
The United States ◽  
Smoking History ◽  
Community Clinic ◽  
Low Dose Ct ◽  
The Impact

e19177 Background: Lung cancer is the leading cause of cancer deaths in the United States with only 15% alive 5 years after diagnosis. In 2013, USPSTF recommended annual screening for LDCT in high risk individuals. Studies had shown a 20% lower mortality (NELSON trial showed significantly lower lung cancer mortality) with LDCT screening. We aimed to assess the extent to which the guideline for lung cancer screening is being adopted in a community clinic. Methods: A retrospective review of electronic medical record of patients aged 55-80 years with no history of lung cancer who visited a primary care provider in a community clinic in New Jersey from October 2014- December 2019 was done. All records with any form of documentation of smoking were identified electronically. The records of those meeting the criteria (30 pack-year smoking history and currently smoking or have quit within the past 15 years) were reviewed manually to check 1) whether they are eligible for screening, 2) if eligible whether low dose CT has been recommended by the provider and 3) once recommended has it been done and followed by the patients. Results: 359 individuals with documented smoking history were identified. Of those 38.8 % (139/359) had a proper documentation (includes both PPD and number of years of smoking) of smoking history based on which high risk individuals could be identified. Of those 37 individuals met the criteria for lung cancer screening. 62% (23/37) had CT chest ordered at some point of time (16.2% for a different indication and the rest for lung cancer screening). Only 52.2% (12/23) of the patients followed the recommendations and got a LDCT done. Among those 50% (6/12) had follow up CT, 50 % (3/6) of those did it on a regular annual basis while the rest 50% (3/6) did it irregularly. 3 patients followed the annual CT screening for lung cancer. Conclusions: Based on these we note that almost half a decade since the recommendation has been established only a small proportion received the care and a still smaller minority followed it. It reflects the dearth of information regarding the guideline among providers and the lack of awareness of the need to follow among patients. This puts forward need for further interventions for implementation of the guidelines at all levels of care for lung cancer prevention. Measures include analyzing the areas of deficiency through questionnaires for patients and providers. Creating awareness on the need for accurate documentation of smoking history and the impact it can have on care delivered. Educating patients about the benefits in health outcome by following the recommendations.

scholarly journals National Lung Cancer Screening Utilization Trends in the Veterans Health Administration

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Jennifer A Lewis ◽  
Lauren R Samuels ◽  
Jason Denton ◽  
Gretchen C Edwards ◽  
Michael E Matheny ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
High Risk ◽  
Medical Center ◽  
Lung Cancer Screening ◽  
Smoking History ◽  
High Risk Population ◽  
Veterans Health ◽  
Health Administration ◽  
Common Procedure

Abstract Background Many Veterans are high risk for lung cancer. Low-dose computed tomography (LDCT) is an effective strategy for lung cancer early detection in a high-risk population. Our objective was to describe and compare annual and geographic utilization trends for LDCT screening in the Veteran’s Health Administration (VHA). Methods A national retrospective cohort of screened Veterans from January 1, 2011 to May 31, 2018 was used to calculate annual and regional rates of initial LDCT utilization per 1000 eligible Veterans. We identified Veterans with a first LDCT exam using common procedure terminology codes G0297 or 71250 and described as “lung cancer screening,” “screening,” or “LCS.” The number of screen-eligible Veterans per year was calculated as unique Veterans aged 55 to 80 years seen at a Veterans Affairs medical center (VAMC) in that year, multiplied by 32% (estimated proportion with eligible smoking history). We present 95% confidence intervals (CI) for rates. Results Screened Veterans had a mean age of 66.1 years (standard deviation [SD] = 5.6); 95.5% male; 77.4% Caucasian. There were 119 300 LDCT exams, of which 80 819 (67.7%) were initial. Nationally, initial screens increased from 0 (95% CI = 0.00 to 0.00) in 2011 to 29.6 (95% CI = 29.26 to 29.88) scans per 1000 eligible Veterans in 2018 (Ptrend &lt; .001). Initial screens increased over time within all geographic regions, most prominently in northeastern and Florida VAMCs. Conclusion VHA LDCT utilization increased from 2011 to 2018. However, overall utilization remained low. Future interventions are needed to increase lung cancer screening utilization among eligible Veterans.

scholarly journals Determining the perception of a lung cancer screening programme among high-risk patients in a tertiary referral centre, Kuala Lumpur

2019 ◽  
Vol 29 (1) ◽  
pp. 19-24
Author(s):  
Wei Hao Kok ◽  
Andrea Ban Yu-Lin ◽  
Shamsul Azhar Shah ◽  
Faisal Abdul Hamid
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
High Risk ◽  
Screening Programme ◽  
Lung Cancer Screening ◽  
High Risk Population ◽  
Willingness To Participate ◽  
Tertiary Referral Centre ◽  
Cross Sectional ◽  
Cancer Screening Programme

Background: Lung cancer is the second most common cause of cancer-related death and the third most common cancer in Malaysia. The rising prevalence of lung cancer suggests the need to consider disease screening for early detection, especially in the high-risk population, as it offers the best chance of cure. Objectives: The study aims to determine the willingness of high-risk respondents to participate in a lung cancer screening programme if made available to them, and to determine their attitude towards lung cancer screening and explore factors that might affect participation in a screening programme. Method: This is a cross-sectional, descriptive study over 6 months conducted in adult patients attending medical clinics in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) using face-to-face administered questionnaires. Results: In total 180 respondents were analysed. There were 177 (98.3%) males. Mean age was 59.8 ± 9.1 years. Of the respondents, 138 (76.7%) had poor knowledge about cancer screening. Former smokers comprised 119 (66.1%) of the participants, and 61 (33.9%) were current smokers. In total, 141 (78.3%) respondents indicated willingness to participate in a lung cancer screening programme. Out of this group, 68 (48.2%) respondents were unwilling to pay for the procedure. Only 18 (12.8%) were unwilling to undergo lung cancer treatment if detected early. Conclusions: Awareness about general cancer screening is low. Our study showed that when informed of their high-risk status, respondents were willing to participate in lung cancer screening. There should be more health programmes to promote and raise awareness about lung cancer.

Bimodality Lung Cancer Screening in High-risk Patients: a preliminary report

CHEST Journal ◽  
2004 ◽  
Vol 126 (4) ◽  
pp. 749S
Author(s):  
Gregory M. Loewen ◽  
DongFeng Tan ◽  
Donald Klippenstein ◽  
Zachary Grossman ◽  
Enriqueta Nava ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
High Risk ◽  
Preliminary Report ◽  
Lung Cancer Screening ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals 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 ◽  
2015 ◽  
Vol 5 (7) ◽  
pp. e008254 ◽  
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

Implementation of a Lung Cancer Screening Program in Two Federally Qualified Health Centers

2021 ◽  
pp. 003335492097171
Author(s):  
Lesley Watson ◽  
Megan M. Cotter ◽  
Shauna Shafer ◽  
Kara Neloms ◽  
Robert A. Smith ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Screening Program ◽  
Lung Cancer Screening ◽  
Pilot Project ◽  
Health Centers ◽  
Smoking History ◽  
Federally Qualified Health Centers ◽  
Cancer Society ◽  
Improved Outcomes

Using low-dose computed tomography (LDCT) to screen for lung cancer is associated with improved outcomes among eligible current and former smokers (ie, aged 55-77, at least 30-pack–year smoking history, current smoker or former smoker who quit within the past 15 years). However, the overall uptake of LDCT is low, especially in health care settings with limited personnel and financial resources. To increase access to lung cancer screening services, the American Cancer Society partnered with 2 federally qualified health centers (FQHCs) in Tennessee and West Virginia to conduct a pilot project focused on developing and refining the LDCT screening referral processes and practices. Each FQHC was required to partner with an American College of Radiology–designated lung cancer screening center in its area to ensure high-quality patient care. The pilot project was conducted in 2 phases: 6 months of capacity building (January–June 2016) followed by 2 years of implementation (July 2016–June 2018). One site created a sustainable LDCT referral program, and the other site encountered numerous barriers and failed to overcome them. This case study highlights implementation barriers and factors associated with success and improved outcomes in LDCT screening.

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