scholarly journals Lung cancer screening rates remain very low among current and former smokers

Cancer ◽  
2017 ◽  
Vol 123 (12) ◽  
pp. 2189-2189 ◽  
Author(s):  
Carrie Printz
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Lung Cancer Screening ◽  
Former Smokers

scholarly journals SMOKING CESSATION ATTEMPTS AND EXPERIENCE AMONG CURRENT AND FORMER SMOKERS ELIGIBLE FOR LUNG CANCER SCREENING

CHEST Journal ◽  
2020 ◽  
Vol 158 (4) ◽  
pp. A2369-A2370
Author(s):  
Mayuko Fukunaga ◽  
Catherine Fiore ◽  
Jennifer Kodela ◽  
Angela Patterson ◽  
Kimberly Fisher ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Smoking Cessation ◽  
Cancer Screening ◽  
Lung Cancer Screening ◽  
Former Smokers

Awareness and interest in lung cancer screening among current and former smokers: findings from the ITC United States Survey

2019 ◽  
Vol 30 (7) ◽  
pp. 733-745 ◽  
Author(s):  
Anushree Sharma ◽  
Karin Kasza ◽  
Andrew Hyland ◽  
K. Michael Cummings ◽  
Maansi Bansal-Travers ◽  
...  
Keyword(s):  
United States ◽  
Lung Cancer ◽  
Cancer Screening ◽  
Lung Cancer Screening ◽  
Former Smokers

scholarly journals Using a Patient Decision Aid Video to Assess Current and Former Smokers’ Values About the Harms and Benefits of Lung Cancer Screening With Low-Dose Computed Tomography

2018 ◽  
Vol 3 (1) ◽  
pp. 238146831876988 ◽  
Author(s):  
Aubri S. Hoffman ◽  
Andrea P. Hempstead ◽  
Ashley J. Housten ◽  
Vincent F. Richards ◽  
Lisa M. Lowenstein ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Cancer Screening ◽  
Decision Aid ◽  
Low Dose ◽  
Lung Cancer Screening ◽  
Anticipated Regret ◽  
Potential Benefits ◽  
Former Smokers ◽  
Low Dose Computed Tomography

Background. Recent policy changes require discussing the potential benefits and harms of lung cancer screening with low-dose computed tomography. This study explored how current and former smokers value potential benefits and harms after watching a patient decision aid, and their screening intentions. Methods. Current or former smokers (quit within 15 years) with no history of lung cancer watched the decision aid and responded to items assessing the value of potential benefits and harms in their decision making, and their screening intentions. Results. After viewing the decision aid, participants ( n = 30; mean age 61.5 years, mean 30.4 pack-year history) were well-informed (mean 80.5% correct responses) and rated anticipated regret and finding cancer early as highly important in their decision (medians >9 out of 10), along with moderate but variable concerns about false positives, overdiagnosis, and radiation exposure (medians 7.0, 6.0, and 5.0, respectively). Most participants (90.0% to 96.7%) felt clear about how they personally valued the potential benefits and harms and prepared for decision making (mean 86.7 out of 100, SD = 21.3). After viewing the decision aid, most participants (90%) intended to discuss screening with their doctor. Limitations. The study is limited to current and former smokers enrolled in a tobacco treatment program, and it may not generalize to other patient populations. Conclusions. The majority of current and former smokers were strongly concerned about anticipated regret and finding cancer early, while concerns about radiation exposure, false positives, and overdiagnosis were variable. After viewing the decision aid, current and former smokers reported strong preparedness and intentions to talk with their doctor about lung cancer screening with low-dose computed tomography.

scholarly journals The impact of perceived risk, screening eligibility and worry on preference for lung cancer screening: a cross-sectional survey

2020 ◽  
Vol 6 (1) ◽  
pp. 00158-2019
Author(s):  
Katharine See ◽  
Renee Manser ◽  
Elyse R. Park ◽  
Daniel Steinfort ◽  
Bridget King ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Cancer Risk ◽  
Lung Cancer Risk ◽  
Lung Cancer Screening ◽  
Validated Questionnaire ◽  
Significant Difference ◽  
Perceived Seriousness ◽  
Former Smokers ◽  
The Impact

Lung cancer screening is effective at reducing lung cancer deaths when individuals at greatest risk are screened. Recruitment initiatives target all current and former smokers, of whom only some are eligible for screening, potentially leading to discordance between screening preference and eligibility in ineligible individuals. The objective of the present study was to identify factors associated with preference for screening among ever-smokers.Ever-smokers aged 55–80 years attending outpatient clinics at three Australian hospitals were invited. The survey recorded: 1) demographics; 2) objective lung cancer risk and screening eligibility using the Prostate Lung Colon Ovarian 2012 risk model; and 3) perceived lung cancer risk, worry about and seriousness of lung cancer using a validated questionnaire. Multivariable ordinal logistic regression identified predictors of screening preference.The survey was completed by 283 individuals (response rate 27%). Preference for screening was high (72%) with no significant difference between low-dose computed tomography screening-eligible and -ineligible individuals (77% versus 68%, p=0.11). Worry about lung cancer (adjusted-proportional odds ratio (adj-OR) 1.31, 95% CI 1.08–1.58; p=0.007) and perceived seriousness of lung cancer (adj-OR 1.31, 95% CI 1.05–1.64; p=0.02) were associated with higher preference for lung cancer screening while screening eligibility was not. The concept of “early detection” was the most important driver to have screening while practical obstacles like difficulty travelling to the scan or taking time off work were the least important barriers to screening.Most current or former smokers prefer to undergo screening. Worry about lung cancer and perceived seriousness of the diagnosis are more important drivers for screening preference than eligibility status.

Completion of lung cancer screening after a baseline order for LDCT at five diverse health systems.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10506-10506
Author(s):  
Christine Neslund-Dudas ◽  
Amy Tang ◽  
Elizabeth Alleman ◽  
Jennifer Elston Lafata ◽  
Stacey A. Honda ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Logistic Regression ◽  
Cancer Screening ◽  
Health System ◽  
Black Men ◽  
Health Systems ◽  
Lung Cancer Screening ◽  
Smoking History ◽  
Former Smokers

10506 Background: In 2014 and 2015, the Affordable Care Act required coverage of, and CMS began reimbursing for lung cancer screening (LCS). Previous studies have shown that when new screening tests or treatments become available, disparities in disease outcomes often increase due to those with fewer resources having less access and greater barriers to care. African American men have historically had higher incidence of and death due to lung cancer than white males in the U.S., raising concerns regarding access to LCS and the potential for increases in disparities in lung cancer. We aimed to determine whether individual or neighborhood level factors were associated with completion of a baseline screening after an order for LCS low dose CT (LDCT) was placed. Methods: In a retrospective study conducted within the five health systems of the Lung Population-based Research to Optimize the Screening Process (PROSPR) Consortium, we determined adherence to baseline LDCT after a health care provider placed an order for LCS (January 2014 through June 2019). Follow-up was available through September 2019. Patients of interest for this analysis were current or former smokers, age 55 to 80 with a 30+ pack-year smoking history. Smoking history and other individual level variables were determined through electronic medical records. Neighborhood factors were derived from the 2010 Census and multivariable logistic regression was used. Results: Of the 13,920 patients that had at least one order for a baseline LCS exam, 14.1% were non-Hispanic Black, 70.3% were non-Hispanic White, and 15.7% were of other or unknown race. Overall, 61.2% of patients completed a LDCT within 90 days and 71.9% completed a scan by the end of follow-up. Completion of a baseline scan differed by health system (LDCT at 90-days, range 51% - 84%, p<0.0001) and increased in general across scan year (range 49.1%-66.0%, p <0.001). In multivariate logistic regression models, males (aOR=1.15, 95% CI 1.07-1.23, p=<0.0001), former smokers (aOR=1.31, 95% CI 1.21-1.40, p <0.0001), and those with a prior history of any cancer (aOR=1.16, 95% CI 1.02-1.32, p=0.03) were more likely to complete LDCT. Blacks were marginally less likely to have completed a baseline LDCT (aOR=0.90, 95% CI 0.81-1.00, p=0.06) within 90 days of an order. Sex modified the associations of race on completion of orders (p=0.08) (Black men aOR=0.81, 95% CI 0.70-0.94, p=0.006 ; Black women aOR=0.99, 95% CI 0.86-1.14, p=0.89). Conclusions: This multisite study indicates Black men in particular may have a lower likelihood of completing a baseline LCS after an order for screening is placed. As lung cancer screening programs move forward, attention should be given to factors associated with reduced uptake and adherence of screening to ensure disparities in lung cancer outcomes do not persist and increase. Provider and health system factors that may impact LCS uptake should be explored in future studies.

Community-based lung cancer screening adherence to Lung-RADS recommendations.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10540-10540
Author(s):  
Roger Kim ◽  
Katharine A. Rendle ◽  
Christine Neslund-Dudas ◽  
Robert T. Greenlee ◽  
Andrea N. Burnett-Hartman ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Clinical Trials ◽  
Cancer Screening ◽  
Family Income ◽  
Smoking Status ◽  
Lung Cancer Screening ◽  
System Level ◽  
Community Based ◽  
Screening Process ◽  
Former Smokers

10540 Background: In the NLST and NELSON trials, most low-dose CT (LDCT) screen-detected lung cancers were not diagnosed during the first round of screening, suggesting that longitudinal adherence to lung cancer screening (LCS) recommendations is key. Adherence was as high as 95% in clinical trials, but limited data exist regarding LCS adherence in clinical practice. We aimed to determine adherence to Lung-RADS recommendations among community-based patients undergoing LCS. Methods: We performed a multicenter retrospective cohort study of patients screened for lung cancer at healthcare systems within the Lung Population-based Research to Optimize the Screening Process (PROSPR) Consortium. We included 55-80 year-old current or former smokers who received a baseline (T0) LDCT with a Lung-RADS score between January 1, 2015 and September 30, 2017 and excluded patients who were diagnosed with lung cancer prior to the T0 scan. Over a 24-month period, we calculated the proportion of patients adherent to Lung-RADS recommendations and evaluated associations with patient-level (age, sex, race, ethnicity, smoking status, body mass index, Elixhauser comorbidities, year of T0 scan, and Lung-RADS score) and census tract (median family income, level of education) data, using multivariable logistic regression with mixed effects to account for site variability. Results: Of the 6,723 patients in our cohort (median age 65 years [IQR 60-69]; 45.1% female; 73.0% white; 59.0% current smokers), 5,583 (83.0%) had Lung-RADS 1 or 2 T0 scans, 733 (10.9%) Lung-RADS 3, 274 (4.1%) Lung-RADS 4A, and 133 (2.0%) Lung-RADS 4B or 4X. Overall, 55.2% (3,709/6,723) of patients were adherent (Table). In the final multivariable model, Black patients had reduced adherence compared to white patients (adjusted odds ratio [aOR] 0.79, 95% CI 0.66-0.94), while greater adherence was observed in former smokers compared to current smokers (aOR 1.33, 95% 1.19-1.49). Compared to individuals with a negative T0 scan (Lung-RADS 1 or 2), those with Lung-RADS 3 (aOR 1.56, 95% CI 1.31-1.86), 4A (aOR 1.63, 95% CI 1.24-2.15), or 4B/4X (aOR 3.59, 95% CI 2.30-5.60) T0 scans had greater odds of adherence. Conclusions: In the largest study of real-world patients receiving LCS to date, adherence to Lung-RADS recommendations is lower than previously observed in clinical trials. Our results highlight the need for further study of system-level mechanisms to improve longitudinal LCS adherence rates.[Table: see text]

scholarly journals Randomized Electronic Promotion of Lung Cancer Screening: A Pilot

2017 ◽  
pp. 1-6
Author(s):  
Abbie L. Begnaud ◽  
Anne M. Joseph ◽  
Bruce R. Lindgren
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Usual Care ◽  
Task Force ◽  
Intervention Group ◽  
Lung Cancer Screening ◽  
Smoking History ◽  
Care Group ◽  
University Of Minnesota ◽  
Former Smokers

Purpose Screening for lung cancer with low-dose computed tomography is endorsed by the US Preventive Services Task Force, but many eligible patients have yet to be offered screening. Major barriers to the implementation of screening are physician and system related—the requirement for a detailed smoking history, including pack-years, to determine eligibility. We conducted this pilot to determine the feasibility of lung cancer screening (LCS) promotion that would offer screening to eligible persons and patient completion of smoking history to estimate the size of the population of former smokers who may be eligible for LCS in a single health care system. Patients and Methods Two hundred participants were randomly selected from former smokers who were seen at the University of Minnesota Health in the past 2 years and assigned to control (usual care) and electronic promotion, stratified by age. Electronic messages to promote LCS were sent to an intervention group, including a link to complete a detailed smoking history in the electronic health record. Results Of 99 participants, 66 (67%) in the intervention group read the message, 24 (36%) of 66 responded, and 19 (79%) of 24 respondents completed the smoking history. Ten intervention participants and 13 usual care participants were eligible for screening on the basis of pack-year history. Four eligible participants underwent screening in the intervention group compared with one participant in the usual care group. Conclusion Electronic promotion may help identify patients who are eligible for LCS but will not reliably reach all patients because of low response rates. In this sample of former smokers, the majority are ineligible for LCS on the basis of pack-year history. Electronic methods can improve documentation of smoking history.

Barriers to and Interest in Lung Cancer Screening Among Latino and Non-Latino Current and Former Smokers

2019 ◽  
Vol 21 (6) ◽  
pp. 1313-1324
Author(s):  
Sanja Percac-Lima ◽  
Jeffrey M. Ashburner ◽  
Steven J. Atlas ◽  
Nancy A. Rigotti ◽  
Efren J. Flores ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Lung Cancer Screening ◽  
Former Smokers
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