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  P3.11 - Screening and Early Detection (Not CME Accredited Session) (ID 977)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall

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    P3.11-04 - Trends and Barriers in Lung Cancer Screening Implementation Across the United States. (ID 13925)

    12:00 - 13:30  |  Author(s): Amy Copeland
    • Abstract
    • Slides

    Background
    

    In 2010, the National Lung Screening Trial was halted after showing a 20% reduction in mortality for high risk individuals when three years of annual lung cancer screening was performed by low dose computed tomography(NEJM, 2011). Many questions remained about whether screening could be properly implemented in non-academic, community settings. Lung Cancer Alliance developed a National Framework for Excellence in Lung Cancer Screening and Continuum of Care in 2012 and began a nationwide network dedicated to responsible lung cancer screening. The Screening Center of Excellence (SCOE) designation requires a center to ensure shared decision-making, comply with best practice standards, work with a multidisciplinary care team, deliver or refer for smoking cessation, provide results in a timely manner, and meet technical specifications set by the American College of Radiology. Our aim is to promote high-quality, responsible lung cancer screening throughout the United States, including in community settings where most lung cancer is diagnosed.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    From 2012 through 2017, over 500 centers were designated as SCOEs. These centers represented 42 states and more than 60% were from community/non-academic centers. High-risk individuals who come to the Lung Cancer Alliance website or contact the organization by phone to find a screening center are directed to a SCOE. A data collection effort in 2017, being repeated in 2018, collected comprehensive information about the state of lung cancer screening and care at the SCOEs. Nearly 70% of SCOEs responded to the 2017 survey.

    4c3880bb027f159e801041b1021e88e8 Result
    

    The SCOE program data shows that screening is being performed widely across the United States, including in non-academic centers. For centers who were able to provide numbers of screenings performed and diagnoses, we identified a clear trend in diagnosis of Stage 1 lung cancer, indicating these screenings are able to find lung cancer early. We also identified a number of implementation challenges around referral patterns, insurance and billing, and determining appropriate risk criteria. Rates of adherence to both annual scans and recommended follow-up varied widely across different institutions indicating a key area of focus for future implementation research.

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    We have shown that a patient advocacy group working with medical professionals can help deliver high quality care to a broad population. Data collection from the SCOEs provides a snapshot of the state of lung cancer screening in the United States that underscores the success of screening and the importance of early detection but also identifies barriers in implementation that still need to be addressed.

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