Browsing by Subject "Lung cancer screening"

Now showing 1 - 5 of 5
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    A National Quality Improvement Study Identifying and Addressing Cancer Screening Deficits Due To the COVID-19 Pandemic
    (Wiley, 2022) Joung, Rachel Hae-Soo; Nelson, Heidi; Mullett, Timothy W.; Kurtzman, Scott H.; Shafir, Sarah; Harris, James B.; Yao, Katharine A.; Brajcich, Brian C.; Bilimoria, Karl Y.; Cance, William G.; Surgery, School of Medicine
    Background: Cancer-related deaths over the next decade are expected to increase due to cancer screening deficits associated with the coronavirus disease 2019 (COVID-19) pandemic. Although national deficits have been quantified, a structured response to identifying and addressing local deficits has not been widely available. The objectives of this report are to share preliminary data on monthly screening deficits in breast, colorectal, lung, and cervical cancers across diverse settings and to provide online materials from a national quality improvement (QI) study to help other institutions to address local screening deficits. Methods: This prospective, national QI study on Return-to-Screening enrolled 748 accredited cancer programs in the United States from April through June 2021. Local prepandemic and pandemic monthly screening test volumes (MTVs) were used to calculate the relative percent change in MTV to describe the monthly screening gap. Results: The majority of facilities reported monthly screening deficits (colorectal cancer, 80.6% [n = 104/129]; cervical cancer, 69.0% [n = 20/29]; breast cancer, 55.3% [n = 241/436]; lung cancer, 44.6% [n = 98/220]). Overall, the median relative percent change in MTV ranged from -17.7% for colorectal cancer (interquartile range [IQR], -33.6% to -2.8%), -6.8% for cervical cancer (IQR, -29.4% to 1.7%), -1.6% for breast cancer (IQR, -9.6% to 7.0%), and 1.2% for lung cancer (IQR, -16.9% to 19.0%). Geographic differences were not observed. There were statistically significant differences in the percent change in MTV between institution types for colorectal cancer screening (P = .02). Conclusion: Cancer screening is still in need of urgent attention, and the screening resources made available online may help facilities to close critical gaps and address screenings missed in 2020. Lay summary: Question: How can the effects of the coronavirus disease 2019 pandemic on cancer screening be mitigated? Findings: When national resources were provided, including methods to calculate local screening deficits, 748 cancer programs promptly enrolled in a national Return-to-Screening study, and the majority identified local screening deficits, most notably in colorectal cancer. Using these results, 814 quality improvement projects were initiated with the potential to add 70,000 screening tests in 2021. Meaning: Cancer screening is still in need of urgent attention, and the online resources that we provide may help to close critical screening deficits.
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    Disparities and Poor Outcomes for Patients Diagnosed with Lung Cancer Through the Emergency Department
    (Indiana Medical Student Program for Research and Scholarship (IMPRS), 2021) Blucker, Nathaniel; Pettit, Nicholas; Emergency Medicine, School of Medicine
    Background and Hypothesis: Cancer is currently the second leading cause of death in the United States, with lung cancer being the leading cause of cancer death. Approximately 40% of patients with lung cancer are diagnosed emergently, many at advanced stages, and occur despite the existence of lung cancer screening. However, local trends among Eskenazi Health patients are unknown. We hypothesize that individuals diagnosed with lung cancer through emergency presentations at Eskenazi Health will experience greater negative outcomes than individuals who are diagnosed through elective routes. Experimental Design of Project Methods: This is a retrospective chart review utilizing the Eskenazi Health electronic medical health records system. Patients with an ICD-coded lung cancer diagnosis within the five-year period between 2016 and 2021 were analyzed. We compared characteristics, health care utilization, and outcomes for adult patients who had a diagnosis of lung cancer. Our primary outcome was the number of patients diagnosed with lung cancer emergently. Results: Thus far, 74% of the cases viewed have been considered emergent diagnoses of lung cancer. Of the total cases, 54% of emergent diagnoses and 32% of non-emergent are stage IV. Mortality rates of both stage IV groups respectively are 74% and 62.5%. Overall mortality rates were 56.6%, and 45.9% for emergent and non-emergent diagnoses respectively. Amongst the diagnoses viewed, 93.8% failed to occur due to lung cancer screening. Rates of screening amongst the emergent group were lower at 6.6%, as opposed to non-emergent cases at 24%. Conclusion and Potential Impact: A significant portion of lung cancer diagnoses at Eskenazi Health are taking place due to presentation through emergent routes. The stage of these diagnoses suggests possible missed opportunities for earlier diagnosis. Additionally, a large part of the patient population currently qualifies for lung cancer screening despite low rates of screening being performed. Future work should emphasize reducing the number of patients emergently diagnosed with lung cancer.
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    Lung Cancer Screening Knowledge in Four Internal Medicine Programs
    (Sage, 2022) Urrutia Argueta, Samuel; Basnet, Nishraj; Abdul-Kafi, Owais; Hanna, Nasser; Medicine, School of Medicine
    Introduction: Lung cancer remains the leading cause of cancer-related death in the United States. Low density CT (LDCT) has been shown to reduce mortality in high-risk populations. Recognizing and mitigating gaps in knowledge in early medical training could result in increased utilization of screening CT in high risk-populations. Methods: An electronic survey was conducted among Internal Medicine (IM) residents at 4 academic programs in the Midwestern United States. A survey was distributed to evaluate knowledge about high-risk populations, mortality benefits, and a comparison in mortality benefits between LDCT and other screening modalities using number needed to screen (NNS). Results: There was a 46.6% (166/360) response rate. Residents correctly answered an average of 2.9/7 (43.1%) questions. PGY-1 (post-graduate year) and PGY-2 residents performed better than PGY-3 (P = .022). Only 1/3 rd of all respondents correctly identified the population needed to be screened. Over 80% of residents thought screening with LDCT had a cancer-specific mortality benefit but were evenly split (except Program 2 residents), on recognizing an all-cause mortality benefit with LDCT, (P = .016). Only 7.7% thought women benefited the most from LDCT. Self-assess and attained knowledge were similar among programs. Conclusions: LDCT is a noninvasive intervention with a substantial mortality reduction, especially in states with high rates of smoking, and is widely covered by insurers. With average knowledge score less than 50%, this study shows there is a substantial need to increase the knowledge of LCS in IM residency programs.
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    Understanding lung cancer screening behavior: Racial, gender, and geographic differences among Indiana long-term smokers
    (Elsevier, 2018-02-03) Carter-Harris, Lisa; Slaven, James E.; Monahan, Patrick O.; Shedd-Steele, Rivienne; Hanna, Nasser; Rawl, Susan M.; School of Nursing
    Lung cancer screening is a relatively new screening option. Inequalities related to screening behavior have been documented in other types of cancer screening. Because stage at presentation drives mortality in lung cancer, it is critical to understand factors that influence screening behavior in lung cancer screening in order to intervene. However, we must first understand where disparities exist in lung cancer screening participation in order to effectively guide intervention efforts. Therefore, the purpose of this study was to determine the association of sociodemographic (including key disparity-related variables) and knowledge with lung cancer screening behavior. This cross-sectional, descriptive study used survey methodology to collect data from 438 screening-eligible individuals in the state of Indiana between January and February 2017 and measured sociodemographic variables and knowledge about lung cancer and screening. Key sociodemographic and health status characteristics associated with screening behavior included race, geographic area of residence, income, health insurance, and family history of lung cancer. Of the variables generally reflective of disparities, key differences were noted by race and geographic area of residence with total knowledge scores as well as screening behavior, respectively. Results indicate key differences in race and geographic area of residence that may perpetuate screening behavior disparities. We have a unique opportunity at this early implementation stage in lung cancer screening to learn what variables influence screening behavior from our target patient population. This knowledge can be used to design equitable patient outreach programs, meaningful, tailored patient engagement materials, and effective patient-clinician decision support tools., • Lung cancer screening is a relatively new screening option for long-term smokers. • Key racial and residential differences were noted that may perpetuate screening disparities. • Identifying screening behavior disparities early is critical to effective implementation.
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    Understanding the decision to screen for lung cancer or not: A qualitative analysis
    (Wiley, 2019-12) Burke Draucker, Claire; Rawl, Susan M.; Vode, Emilee; Carter-Harris, Lisa; School of Nursing
    Background Although new screening programmes with low‐dose computed tomography (LDCT) for lung cancer have been implemented throughout the United States, screening uptake remains low and screening‐eligible persons' decisions to screen or not remain poorly understood. Objective To describe how current and former long‐term smokers explain their decisions regarding participation in lung cancer screening. Design Phone interviews using a semi‐structured interview guide were conducted to ask screening‐eligible persons to describe their decisions regarding screening with LDCT. The interviews were transcribed and analysed with conventional content analytic techniques. Setting and participants A subsample of 40 participants (20 who had screened and 20 who had not) were drawn from the sample of a survey study whose participants were recruited by Facebook targeted advertisements. Results The sample was divided into the following five groups based on their decisions regarding lung cancer screening participation: Group 1: no intention to be screened, Group 2: no deliberate consideration but somewhat open to being screened, Group 3: deliberate consideration but no definitive decision to be screened, Group 4: intention to be screened and Group 5: had been screened. Reasons for screening participation decisions are described for each group. Across groups, data revealed that screening‐eligible persons have a number of misconceptions regarding LDCT, including that a scan is needed only if one is symptomatic or has not had a chest x‐ray. A physician recommendation was a key influence on decisions to screen. Discussion and conclusions Education initiatives aimed at providers and long‐term smokers regarding LDCT is needed. Quality patient/provider communication is most likely to improve screening rates.