scholarly journals Lung Cancer Screening: An Evidence-Based Practice Change Project

2021 ◽  
Author(s):  
◽  
Robert Bland
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Literature Review ◽  
Lung Cancer Screening ◽  
Audit And Feedback ◽  
Evidence Based ◽  
Audit Tool ◽  
Cancer Screenings ◽  
Evaluation Phase ◽  
Chi Square Analysis

Practice Problem: Lung cancer is the leading cause of global cancer deaths and is a significant health issue in the US, claiming more than 155,000 lives each year. Lung cancer screening through low dose computed tomography (LDCT) can reduce lung cancer mortality by 20 percent but unfortunately, lung cancer screening is underutilized. PICOT Question: The PICOT question that guided this project was: in a patient population eligible for LDCT lung screening (P), how does auditing of practice with feedback to the providers (I), compared to not doing the interventions as mentioned above (C), increase LDCT lung cancer screenings in the identified population (O), in an eight-week period (T)? Evidence: A thorough literature review was conducted to determine if audit and feedback is an evidence-based strategy for increasing cancer screening rates. The literature review produced ample evidence supporting audit and feedback as an effective strategy for significantly increasing cancer screening rates. Intervention: A lung cancer screening audit tool with essential elements for determining patient eligibility for LDCT lung cancer screening was created for this project, and the face validity of the audit tool was obtained. During the project’s intervention and evaluation phase, each audit tool submitted was analyzed for completeness, and performance feedback was given to the clinic’s providers on a weekly basis. Outcome: Although Chi-Square analysis did not show statistical significance, the number of LDCT lung cancer screening scans nearly doubled during the intervention phase compared to the baseline phase of the project. Conclusion: The continued usage of the lung cancer screening audit and feedback tool is recommended for increasing the number of LDCT lung cancer screenings.

Lung Cancer Screening, Cancer Treatment, and Addressing the Continuum of Health Risks Caused by Tobacco

2016 ◽  
pp. 223-229 ◽  
Author(s):  
Graham W. Warren ◽  
Jamie S. Ostroff ◽  
John R. Goffin
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Cancer Treatment ◽  
Tobacco Use ◽  
Health Risks ◽  
Lung Cancer Screening ◽  
Adverse Outcomes ◽  
Evidence Based ◽  
Patients With Cancer ◽  
Preventable Risk Factor

Tobacco use is the largest preventable risk factor for the development of several cancers, and continued tobacco use by patients with cancer and survivors of cancer causes adverse outcomes. Worldwide tobacco control efforts have reduced tobacco use and improved health outcomes in many countries, but several countries continue to suffer from increased tobacco use and associated adverse health effects. Continued tobacco use by patients undergoing cancer screening or treatment results in continued risk for cancer-related and noncancer-related health conditions. Although integrating tobacco assessment and cessation support into lung cancer screening and cancer care is well justified and feasible, most patients with cancer unfortunately do not receive evidence-based tobacco cessation support. Combining evidence-based methods of treating tobacco addiction, such as behavioral counseling and pharmacotherapy, with practical clinical considerations in the setting of lung cancer screening and cancer treatment should result in substantial improvements in access to evidence-based care and resultant improvements in health risks and cancer treatment outcomes.

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.

Implementation of an Evidence-Based Tobacco Use Treatment Intervention in the Context of Lung Cancer Screening

2018 ◽  
Author(s):  
Jamie S. Ostroff ◽  
Donna Shelley
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Tobacco Use ◽  
Lung Cancer Screening ◽  
Helical Computed Tomography ◽  
Evidence Based ◽  
Treatment Interventions ◽  
Smoking Cessation Treatment ◽  
Tobacco Treatment

Lung cancer screening using low-dose helical computed tomography is now recommended for early detection of lung cancer. This case study provides an overview of a study that is testing the effectiveness of tobacco treatment interventions for high-risk smokers seeking lung cancer screening and examining factors that may influence implementation process and sustainability for delivering effective models of smoking cessation treatment in lung cancer screening settings. The focus of the case study is a description of how and why two implementation frameworks were applied to evaluate the implementation outcomes and additional multilevel factors (i.e., organization and intervention characteristics) that may influence effective implementation of evidence-based tobacco use treatment interventions in the context of lung cancer screening. Ultimately, implementation of high-quality tobacco treatment in lung cancer screening settings is likely to further reduce tobacco-related cancer morbidity and mortality.

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