Virtual Library
Start Your Search
Robert A. Smith
Author of
-
+
MA20 - Implementation of Lung Cancer Screening (ID 923)
- Event: WCLC 2018
- Type: Mini Oral Abstract Session
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/25/2018, 15:15 - 16:45, Room 206 F
-
+
MA20.07 - Lung Cancer Screening for Limited-Resource Patients: Preliminary Findings from a Low-dose CT Pilot Program (ID 13910)
15:55 - 16:00 | Author(s): Robert A. Smith
- Abstract
- Presentation
Background
Low-dose CT (LDCT) screening for lung cancer in adults at high-risk is associated with a reduction in lung cancer mortality in high-risk adults, yet screening rates remain low. Increasing access to high-quality lung cancer screening is critical to further reducing deaths from the disease. In 2015 the American Cancer Society implemented a pilot program to identify successful strategies for improving access to LDCT in Memphis, Tennessee and Charleston, West Virginia through partnerships with Federally Qualified Health Centers (FQHCs) that serve limited resource patients. The program focused on developing systems within FQHCs to identify and refer patients for LDCT, and helping FQHCs build relationships with local accredited screening facilities to deliver lung cancer screening and navigate patients through the screening process and any necessary follow-up. This program is novel because it brings emerging technology in lung cancer screening and early detection to low-resource FQHCs that typically do not have access to state-of-the-art interventions. As such, the pilot affords important opportunities to identify facilitators and barriers to conducting LDCT in under-resourced areas. This presentation focuses on evaluation results for the program to-date, emphasizing barriers to implementation experienced by FQHCs and their screening partners.
a9ded1e5ce5d75814730bb4caaf49419 Method
Participating FQHCs submitted quarterly monitoring reports tracking the number of: patients assessed for LDCT eligibility, shared decision-making (SDM) visits, patients screened, and screening results. Evaluators conducted site visits and stakeholder interviews with staff from FQHCs and their screening partners in summer 2017 and 2018 to capture nuanced information about program implementation.
4c3880bb027f159e801041b1021e88e8 Result
Participating FQHCs conducted 387 SDM discussions and have screened 252 patients to date. Participants expressed uncertainty about the definition and process of SDM, and difficulty with tracking and billing for these patient-provider encounters. During the project period, both sites established processes for follow-up screening and referrals based on initial screening results (LRADs 1-4). Interview data provided insight into the major challenges and successes to piloting and implementing a new protocol. Both sites struggled to agree on the correct follow-up for LRADS 3 and 4 patients. Through piloting and discussion with clinic leadership, one site successfully implemented clear, logical follow-up procedures based on staff capacity and clinical guidelines.
8eea62084ca7e541d918e823422bd82e Conclusion
Our evaluation findings, including key lessons learned and recommendations, add to the growing knowledge base of effective lung cancer screening practices and may be used to inform and guide health systems looking to initiate similar programs, particularly those in low-resource settings.
6f8b794f3246b0c1e1780bb4d4d5dc53Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
-
+
P1.02 - Advocacy (Not CME Accredited Session) (ID 934)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
-
+
P1.02-03 - The Role of Lung Cancer Advocacy Organizations in Biomarker Testing (ID 12003)
16:45 - 18:00 | Author(s): Robert A. Smith
- Abstract
Background
In the past 10 years, major advances have been made in our understanding and treatment of lung cancer. Lung cancer is now recognized as not just a single disease, but rather comprises many subtypes, each with unique molecular characteristics or biomarkers. Most new treatment options developed and under development for non-small cell lung cancer (NSCLC) target specific biomarkers, and these targeted therapies are improving outcomes in patients with the applicable biomarker. Despite this progress, biomarker testing is often viewed as an optional service by both patients and their healthcare team.
a9ded1e5ce5d75814730bb4caaf49419 Method
In March 2018, a roundtable was convened consisting of executives from lung cancer advocacy organizations and key opinion leaders in the lung cancer field to discuss trends in biomarker testing for patients with lung cancer. The main objective of the roundtable was to develop an action plan to increase awareness of biomarker testing to ensure all lung cancer patients receive the most effective treatment.
4c3880bb027f159e801041b1021e88e8 Result
Several barriers were identified that may contribute to suboptimal biomarker testing including lack of patient and physician awareness, inadequate tissue sampling, slow turn-around time, limited availability in some community settings, and health policy issues surrounding access, cost, and reimbursement. Patient advocacy groups are well positioned to address the lack of patient awareness with education campaigns. However, the lack of consistent language to describe biomarker testing among organizations is a barrier. To address this issue, advocacy groups need to align on common terminology and messaging with regard to biomarkers. Two potential approaches to achieve this goal include: 1) collaboration to develop joint educational material or 2) collaboration to develop a shared consensus statement including best practices and common core items or ‘building blocks’ for use by each organization to develop their own materials. As a first step, consistent messaging with regard to the Who, What, When, Where, Why, and How of biomarker testing are needed. Understanding gaps in physician knowledge regarding biomarker testing and development of initiatives to address these gaps are also warranted.
8eea62084ca7e541d918e823422bd82e Conclusion
Additional patient and physician education are needed to establish biomarker testing as part of standard of care in patients with advanced-stage NSCLC, with the ultimate goal being that the patient has a full biomarker panel available (or at least tests in progress) at their first appointment with an oncologist. A unified effort from lung cancer advocacy organizations, healthcare providers, and industry partners is needed to achieve this goal.
6f8b794f3246b0c1e1780bb4d4d5dc53
