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Karen Alisa Braithwaite
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EP1.11 - Screening and Early Detection (ID 201)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Screening and Early Detection
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.11-10 - Creating a Comprehensive Lung Cancer Screening Program to Diagnose Early Stage Lung Cancers (Now Available) (ID 79)
08:00 - 18:00 | Presenting Author(s): Karen Alisa Braithwaite
- Abstract
Background
Objective: The goal was to create a comprehensive lung cancer screening program at our Cancer Center that integrates evidence-based results as a way to identify early stage lung cancers in the high risk population of our community.
Literature review: Lung cancer is the third most common type of cancer diagnosed in the United States, but it is the leading cause of cancer deaths (U.S. Cancer Statistics Working Group, 2018). Lung cancer is most often diagnosed at late stages which have low survival rates. The National Lung Screening Trial (NLST) was an NCI funded trial which determined that screening with low dose CT as compared to chest radiograph would reduce mortality by 20% in high risk populations (Team, 2011). Screenings for breast and colorectal cancer has been associated with improved patient outcomes and sets a precedent for implementing responsible lung cancer screening in high risk populations (Mulshine & D'Amico, 2014).
Method
A comprehensive screening program was designed with a nurse coordinator as the main point person to ensure all screenings had follow up tracking completed. The screening program was designed to function in cooperation with the Hospital Comprehensive Lung Cancer Program as needed based on screening results. Program protocol were set up to include timely result reports to referring physician with clear follow up recommendations and result letters to screening patients. A tracking system was put into place to ensure the necessity of follow up scans are communicated to the patients and completed.
Result
Since the start of our program in October 2012, we have performed 933 initial scans, 647 annual scans and 172 short-term follow up scans. We have diagnosed 13 lung cancers, 3 renal cancers, 1 thyroid cancer, 1 melanoma, 2 thymoma, and 1 breast cancer recurrence.
Conclusion
We have found lung cancer screening to be an effective method of diagnosing early stage lung cancers in high risk populations.
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P2.11 - Screening and Early Detection (ID 178)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Screening and Early Detection
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.11-41 - Improving Annual Adherence in a Community Based Lung Cancer Screening Program (Now Available) (ID 725)
10:15 - 18:15 | Presenting Author(s): Karen Alisa Braithwaite
- Abstract
Background
Lung cancer is the third most common type of cancer diagnosed in the United States, but it is the leading cause of cancer deaths (U.S. Cancer Statistics Working Group, 2018). Lung cancer is most often diagnosed at late stages which have low survival rates. The National Lung Screening Trial (NLST) was an NCI funded trial which determined that screening with annual low dose CT as compared to chest radiograph would reduce mortality by 20% in high risk populations (Team, 2011). Since the implementation of our screening program in 2012 we witnessed a steady increase in our initial screening LDCT scans. However the rate of overall adherence was surprising low at 40.1% despite programmatic efforts to contact patients for annual LDCT scans. The NLST included an impressive level of adherence of 95% in the LDCT group and 93% in the radiography group (Cattaneo II, Meisenberg, Geronimo, Bhandari, Maxted, & Brady-Copertino, 2018). We designed a quality improvement project seeking to increase our annual adherence rate.
Method
At the start of 2018 we created a reminder letter directed towards the patients’ referring providers. Using the existing tracking system which was put into place to ensure the necessity of follow up scans are communicated to the patients and completed, we generated reminder letters to the referring providers as well as the patients for anyone that had a scan in 2017.
Result
Based on our added communications with the referring community providers, we increased our overall adherence rate to 58.2%. Looking at smoking status, current smokers increased their adherence by 15.3%, former smokers increased by 16.1%, recent smokers increased by 23.1%. Looking at patients that indicated they had prior lung disease, we increased their adherence by 15.5%. Those who indicated no prior lung disease, we increased their adherence by 17.8%. Patients who identified a family history of lung cancer we increased their adherence by 18.1%. Those who indicated no family history of lung cancer, we increased their adherence by 17.1%. Patients in their 50s, we increased their adherence by 23.3%. Patients in their 60s, we increased their adherence by 17.5% Patients in their 70s we increased their adherence by 7.8%. Males increased their adherence by 20.1% and females by 14.7%. From 2012-2017, we diagnosed 5 lung cancer and 7 non lung cancers. In 2018 we diagnosed 7 lung cancers and 1 non lung cancer.
Conclusion
We have found communicating with referring community providers as well as patients increase adherence in a community based lung cancer screening program. This led to increased diagnosing of early stage lung cancers in high risk populations.
