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Joelle Thirsk Fathi
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P2.13 - Radiology/Staging/Screening (ID 714)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Radiology/Staging/Screening
- Presentations: 2
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.13-019 - Attrition Rate in Community-Based Lung Cancer Screening: One and Done (ID 10310)
09:30 - 16:00 | Author(s): Joelle Thirsk Fathi
- Abstract
Background:
Community-wide lung cancer screening has the potential to significantly impact lung cancer mortality. Thus, much emphasis has been placed on program development and recruitment of high-risk individuals. Lung cancer screening is a continuum, and shared decision-making focuses on the need for participants to remain engaged. Currently, little is known about screening follow-through in the community setting outside of clinical trials. Thus, we aimed to quantify the rate of attrition in our Lung Cancer Screening Program (LCSP) and identify contributing factors.
Method:
We reviewed all individuals enrolled in our LCSP, which is led by an independently practicing nurse practitioner within a multidisciplinary team, from 2012-2016. We identified all individuals who were closed out of the program, the closure date, and reason for closure. Of these, attrition was defined as declined further screening or lost to follow-up. A formal process for documentation of attrition included failure to respond to a written communication, a minimum of three contact attempts, and a clinical note forwarded to the referring provider.
Result:
Of the 520 individuals enrolled in the LCSP, 23% (122) were officially closed out. Thirteen percent (67/520) were closed out for clinical, geographic, or other identifiable reasons. Attrition from the program was identified to be 11% (55/520). Of the individuals that dropped out, 69% (38/55) were smoking upon enrollment compared to 52% (205/398) of retained individuals (p=0.014). In addition, 78% (43/55) had only one CT scan prior to attrition (Figure). Figure 1
Conclusion:
We identified an 11% attrition rate in our community-based LCSP. Individuals who failed to follow-up with the LCSP were more likely to be current smokers. The majority of individuals who failed to follow-up did not return after the initial CT scan. Future work needs to focus on promoting the continuum of screening and support the highest risk communities to minimize attrition.
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P2.13-021 - Community Network Lung Cancer Screening Experience Underrepresents Medically Underserved and Geographically Remote Individuals (ID 10402)
09:30 - 16:00 | Author(s): Joelle Thirsk Fathi
- Abstract
Background:
The National Lung Screening Trial (NLST) demonstrated a 20% reduction in lung cancer mortality. However, it’s study centers may not have represented remote populations with low socioeconomic status and/or health care access. Previous reports on other cancers have demonstrated higher rates of screening in urban populations, with lower adoption in underserved and geographically remote communities. We aimed to quantify the proportion of screened individuals from medically underserved and geographically remote areas represented in our multi-state hospital network lung cancer screening programs (LCSPs).
Method:
We performed a multi-institution review using data from individuals enrolled in Pacific Northwest LCSPs, which form part of a multi-state hospital network. Individuals from programs spanning Washington State, Oregon, Montana, and Alaska from 2012-2016 were included. Definitions include: medically underserved area [MUA; healthcare resources deficient region], medically underserved population [MUP; area with economic/cultural/linguistic barriers to primary care services], health professional shortage area [HPSA; primary care physician shortage].
Result:
We identified a total of 2,379 screening participants. Of these, 22% (529) resided in a medically underserved area and 5% (108) were from a medically underserved population. Only 9% (216) resided in a HPSA, compared to the combined state data reporting a rate of 20% HPSA residents. Individuals lived a median of 6 miles from the screening site. Data stratified by state is shown in the figure, and demonstrates a high capture rate of individuals residing in MUAs in Montana. Figure 1
Conclusion:
All sites showed poor penetration into communities identified as MUPs and HPSAs. All sites also had poor penetration into MUAs; except for Montana, likely due to its overwhelming rural nature. However, the vast majority of screening participants lived in close proximity to screening centers. Therefore, novel approaches such as telemedicine and mobile screening clinics may be needed to reach underserved populations for LCS.
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WS 02 - IASLC Symposium on the Advances in Lung Cancer CT Screening (Ticketed Session SOLD OUT) (ID 631)
- Event: WCLC 2017
- Type: Symposium
- Track: Radiology/Staging/Screening
- Presentations: 1
- Moderators:
- Coordinates: 10/14/2017, 09:00 - 18:15, F201 + F202 (Annex Hall)
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WS 02.20 - Communicating Complex Issues Simply: Pivotal Role of Nursing in Lung Cancer Screening (ID 10631)
09:00 - 18:15 | Presenting Author(s): Joelle Thirsk Fathi
- Abstract
- Presentation
Abstract:
Lung cancer screening offers a unique opportunity for medicine to closely partner with nursing in detecting lung cancers at earlier, treatable stages, address other tobacco related diseases, and assist patients in smoking cessation efforts. Foundational nursing principles are universal around the world with an emphasis on clinical care, research and implementation science, patient education and health coaching, performance improvement and quality outcomes processes, and patient-centered care. Given this preparation, nursing professionals can be potent if positioned predominantly at the helm of lung cancer screening programs with the most touch-points and direct interaction with screening recipients, over the screening continuum. Lung cancer screening encounters present an opportunity for early rather than late detection of preventable and treatable diseases through low dose CT scan. Additionally, lung cancer screening can be utilized as a transformational health tool by positioning nursing at the center of the integrative care delivery model and drive beneficial health outcomes through direct counseling, and health coaching. This includes facilitating preventive measures that directly impact the natural history of tobacco related diseases through smoking cessation counseling and treatment services and health coaching as it relates to the individual patient, their current health state, and low dose CT scan results. The professional services that nursing is keenly positioned to offer within the multidisciplinary lung cancer screening setting hold great potential for an international sustainable screening model. This presentation will discuss pragmatic, approaches to evidence based screening programs, led by nursing, in which high-risk patients receive the care they need and deserve, encourages active engagement in the critical continuum of screening and opens opportunity for improvements in individual and population health.
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