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Maria Cristina de Avila Meinberg



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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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      EP1.11-06 - Design and Implementation of an Integrated Lung Cancer Prevention and Screening Program Using a Mobile CT in Brazil (Now Available) (ID 1031)

      08:00 - 18:00  |  Author(s): Maria Cristina de Avila Meinberg

      • Abstract
      • Slides

      Background

      Lung cancer is a high-ranking cause of cancer deaths in Brazil. Low dose computerized tomography screening national guidelines has not yet been established, and public primary prevention and tobacco control programs have an inconsistent coverture, especially among the most deprived. The Cancer Prevention Department of Barretos Cancer Hospital has a large tradition in the use of mobile units to reach out and conduct cancer screening in underserved Brazilian populations. This study aims to design an integrated lung cancer prevention and early detection program using a mobile CT unit to reach high-risk lung cancer population.

      Method

      The study is placed in Barretos, Brazil, with an estimated population of 120,000 inhabitants. Tobacco cessation intervention and LDCT screening will be offered in partnership between the municipal health system and Barretos Cancer Hospital. Every smoker seeking health assistance and those identified in active surveys in the community would be offered tobacco cessation support. High-risk individuals matching USPTF criteria will be offered LDCT using a mobile CT unit.

      Result

      Nineteen tobacco cessation teams were formed in different public primary health unities throughout the city. Patient information are stored in a web-based databank (RedCap) and shared between teams. Screening flow was coordinated by municipal health office and Barretos Cancer Hospital. The CT mobile unit is intended to be placed near primary health care centers. It was estimated 3,376 eligible participants. A comprehensive epidemiological questionnaire will be asked, in addition with blood and sputum samples collection for further cancer biomarker studies. Those with symptoms of suspected lung malignancy or poor clinical condition would be excluded from screening. Nodules detected in LDCT screening will be managed under ACR Lung-Rads criteria. A multidisciplinary team will be available to discuss doubtful cases, diagnosis and treatment strategies. Two reports are generated for each LDCT screening exam and sent back to primary care teams, one with educational purposes and another with technical information. Primary care teams were trained, being responsible to manage non-cancer conditions eventually detected on screening. A direct line of communication was set between primary care teams, radiologists and multidisciplinary team.

      Conclusion

      Tobacco cessation and lung cancer screening in high-risk individuals have to be integrated. Since Brazilian health assistance in public system is fragmented, it is imperative to design a coordinated flow and establish communication channels between primary care teams, radiologists and multidisciplinary team. There was good feedback by primary care teams and patients about the impact of screening in the tobacco cessation process.

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