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K. Norris



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    PA02 - Access to Care - Equal Chances in the World? (ID 360)

    • Event: WCLC 2016
    • Type: Patient & Advocacy Session
    • Track: Patient Support and Advocacy Groups
    • Presentations: 1
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      PA02.01 - Access to Care: USA (ID 6759)

      16:00 - 17:30  |  Author(s): K. Norris

      • Abstract
      • Presentation
      • Slides

      Abstract:
      In the United States of America (USA), the public is dangerously uninformed about lung cancer, our nation’s second leading cause of death behind heart disease[1]. Lung cancer accounts for more deaths than any other cancer[2]; more than breast, prostate and colon cancer combined! An estimated 220,000 new cases of lung cancer will be diagnosed the USA in 2016[3] resulting in 158,080 deaths or about 27% of all cancer deaths 2016[4]. Ready access to effective and comprehensive medical care at a reasonable cost is the key to our well-being. This is especially true for lung cancer. For lung cancer patients, access takes many forms, to include diagnosis, treatment and financial support for care and treatment. Regardless, for lung cancer patients, time is of the essence, making quick, effective and affordable access to care critical. This discussion will focus on four areas that affect access to care for lung cancer be it at the diagnostic stage or the treatment and care stage: (1) Stigma: At the outset, the negative bias against lung cancer may weigh against early access to treatment[5]. 68% of advanced cancer patients who have never received cancer care are lung cancer patients6. Cancer patients, healthcare professionals, caregivers and the general public are all equally likely to have a negative bias toward lung cancer[7]. (2) Timely diagnosis: The good news is that thanks to advances in technology, early detection screening using spiral CT has been shown to reduce lung cancer deaths by 16% to 20% ( in a defined population), compared to standard chest x-rays among adults[8]. Yet, only 16% of people will be diagnosed in the earliest stage, when the disease is most treatable[9 ]and at best, early diagnosis is usually the serendipitous result of some other unrelated procedure. Aside from the lack of public awareness that anyone with a set of lungs may be at risk for lung cancer, there remains no standard effective diagnostic tool for lung cancer. The development of affordable diagnostic tools using biomarkers in airway epithelial cells, sputum, blood, breath, and urine for early diagnosis and prediction of high risk individuals is critical. (3) Current and evolving treatment options: Once again, the good news is that treatment options for lung cancer patients are rapidly improving. In the last two years more treatments have been approved by the United States Food and Drug Administration (FDA) for the treatment of lung cancer than had been approved in the prior ten years. Most of the discoveries and associated clinical trials are happening at academic centers yet 80% of lung cancer patients are treated at their local community hospital. New and life savings treatments along with clinical trials are happening so quickly that it is sometimes challenging for these advancements to reach the treating physician thereby limiting ready access of these new treatments to the patient. (4) Cost of treatment and care: The Patient Protection and Affordable Care Act (PPACA), commonly called the Affordable Care Act (ACA) or Obamacare, is a United States federal statute signed into law by President Barack Obama on March 23, 2010. In April 2016, Gallup reported that the percentage of adults who were uninsured dropped from 18% in the third quarter of 2013 to 11% in the first quarter of 2016. Although individual insurance coverage has improved, the rapid pace of discovery and FDA approval of treatments, insurance payors and federal medical care assistance programs have not necessarily kept pace with these advancements in both testing and treatments by not providing insurance coverage, leaving lung cancer patients without the financial ability to pay for needed care. Various organizations such as ESMO, ASCO, ICER and others are attempting to compare drug prices to overall patient benefit through programed algorithms in order to assist payors and patients in treatment decision making. These are often long and laborious projects which may be out of date by the time the recommendations are published, and impede quick access to treatment and care Patients and patient advocates are in a strategically advantageous position to affect change in these four areas in order to provide greater access to care for all lung cancer patients. 1 http://www.medicalnewstoday.com/articles/282929.php#top_10_leading_causes_of_death_in_more_detail 2 http://www.cancer.org/acs/groups/content/@editorial/documents/document/acspc-044552.pdf 3 American Cancer Society. Cancer Facts & Figures 2016. Atlanta: American Cancer Society; 2016. 4 http://www.cancer.org/acs/groups/content/@editorial/documents/document/acspc-044552.pdf 5 LoConte NK, Else-Quest NM, Eickhoff J, Hyde J, Schiller JH. Assessment of Guilt and Shame in Patients With Non-Small-Cell Lung Cancer Compared With Patients With Breast and Prostate Cancer. Clinical Lung Cancer. 2008;9(3):171-8. 6 http://thelungcancerproject.org/#need-for-change 7 http://thelungcancerproject.org/#need-for-change 8 http://www.cancer.org/acs/groups/content/@editorial/documents/document/acspc-044552.pdf 9 http://seer.cancer.gov/statfacts/html/lungb.html

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