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Joelle Thirsk Fathi



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    S01 - IASLC CT Screening Symposium: Forefront Advances in Lung Cancer Screening (Ticketed Session) (ID 853)

    • Event: WCLC 2018
    • Type: Symposium
    • Track: Screening and Early Detection
    • Presentations: 1
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      S01.14 - Coordination of the Lung Cancer CT Screening Experience (ID 11895)

      09:50 - 10:05  |  Presenting Author(s): Joelle Thirsk Fathi

      • Abstract

      Abstract

      Coordination of the Lung Cancer CT Screening Experience

      Tobacco use, including cigarette smoking is the most preventable cause of cancer in the entire world, contributing to one third of all cancers. While 80-90% of all lung cancers are directly correlated with cigarette smoking, tobacco is also identified as playing a direct role in a multitude of other malignancies and chronic diseases, and resides in the top ten contributors to human suffering, disability and death (U.S. Department of Health & Human Services, 2014). Tobacco will shorten the lives of 50% of its users, resulting in approximately 17,000 people dying every day in the world (Cahn, 2018)

      Since the National Lung Screening Trial data demonstrated that lung cancer screening provides a reduction in mortality in high-risk patients, (National Lung Screening Trial Research Team et al., 2011) interest and momentum in the adoption of lung cancer screening in the U.S. and abroad has been on a slow but upward trajectory. Yet only 2-4% of eligible people are getting screened (Jemal & Fedewa, 2017).

      Lung cancer screening patients, by having met high-risk criteria, are a defined and select population of people who could greatly benefit from a sophisticated and well-orchestrated lung cancer screening experience. Coordination of successful, high quality, and comprehensive care of patients in the screening environment is challenging, but screening represents an enormous opportunity to reduce disability and death from tobacco use. It is critical that transformation and refinement of screening practices occurs, to adapt a comprehensive model which encompasses a broader scope of diagnoses, treatments, and patient education.

      Uptake of lung cancer screening has been slow in the U.S., and education around screening needs to be continually promoted. Additionally, we need to continue to develop and refine the roles and responsibilities of all involved in the screening process, including the patient. Current diagnostic and health information technology allows for more precise, easier, faster, and safer care. In the setting of lung cancer screening, low dose computed tomography of the lung can often provide a snapshot into a patient’s overall health and has the potential to alert the healthcare team and the patient to additional potential disease states, to which we are obligated to address.

      Additionally, lung cancer screening is a unique and ideal opportunity to address tobacco cessation with patients. Technology is critical, but can’t replace coordination of care, patient engagement, and education with this invaluable opportunity for detection of tobacco related diseases and tobacco cessation efforts. Screening requirements and the high incidence of abnormal findings on screening scans represents the need for interprofessional collaboration, and a concert of sequential events and highly coordinated care potentially involving many members of different healthcare teams.

      In the setting of healthcare today, with an emphasis on collaboration and coordination of care, screening should be viewed and treated as a long-term commitment by all parties, and engagement and partnership with patients and fellow referring providers is critical in redefining the patient experience and delivery of care. It is not just about the chest CT; in fact, this is minor compared to the potential to intervene, and even halt disease progression and reduce risk with health behavior modification, while realizing earlier diagnosis and intervention, and saving money and lives.

      Cahn, Z., Drope, J., Hamill, S., Gomeshtapeh, F., Liber, Al, Nargis, N., Stoklosa, M.,. (2018). Health Effects. In J. Drope, Schluger, N., (Ed.), The tobacco atlas (pp. 24-25). Atlanta, Georgia: American Cancer Society.

      Jemal, A., & Fedewa, S. A. (2017). Lung Cancer Screening With Low-Dose Computed Tomography in the United States-2010 to 2015. JAMA Oncol, 3(9), 1278-1281. doi:10.1001/jamaoncol.2016.6416

      National Lung Screening Trial Research Team, Aberle, D. R., Adams, A. M., Berg, C. D., Black, W. C., Clapp, J. D., . . . Sicks, J. D. (2011). Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med, 365(5), 395-409. doi:10.1056/NEJMoa1102873

      U.S. Department of Health & Human Services. (2014). The health consequences of smoking—50 years of progress: A report of the Surgeon General 2014, executive summary. Retrieved from http://www.surgeongeneral.gov/library/reports/50-years-of-progress/