But many high-risk patients simply aren’t yet being offered LDCT screening.

“Primary care clinicians have a lot of prevention priorities,” Dr Wender said. “Lung cancer screening is still relatively new. Some primary care clinicians haven’t embraced lung cancer screening yet. Some may not even be aware of the recommendations to offer screening.”


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Persistent lack of awareness of lung cancer screening among patients and physicians alike might be an important factor in low screening rates.

“Patients at high risk of lung cancer don’t know to ask their doctors for this test — and clinicians, especially busy primary care providers, have so many other issues to deal with in a busy clinic visit that lung cancer screening may not often rise to the top of the list,” said Dr Wiener.

It is also possible, however, that LDCT lung cancer screening was underreported by NHIS survey participants. Many patients do not understand that their LDCT imaging exam constitutes a search for lung cancer.

What Is the Solution?

The American Cancer Society is participating in a new National Lung Cancer Roundtable — coalition of government and non-government groups seeking ways to expand access to high-quality lung cancer screening for high-risk populations.

Tracking the proportion of eligible patients offered LDCT screening will be one of the Roundtable’s goals.

“We need to develop tools for radiology facilities, radiologists, and primary care clinicians to increase capacity to screen,” Dr Wiener said. “We need to provide guidance for primary care clinicians, including easy-to-use informed decision tools.  We need to identify policy and coverage barriers and work to address them. Working to increase the availability and ease of use of registries is another goal. We also need to refine recommendations for follow up of abnormal findings, most of which are not cancers.”

Meanwhile, public health information campaigns aimed at current and former smokers could help to raise awareness of the need for screening.

“Doctors’ offices can mail patient education tools to high-risk individuals in advance of an upcoming clinic visit so that patients can learn about lung cancer screening and are prepared to discuss whether the test is right for them at their next appointment,” Dr Wiener said. “Finally, medical centers are beginning to implement automated tools in the electronic medical record to flag providers when they see eligible patients to prompt them to consider ordering a LDCT scan for lung cancer screening.”

“There is a lot of work to do,” she said. “We’re eager to move forward and will stay the course as long as it takes.”

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References

  1. Jemal A, Fedewa SA. Lung cancer screening with low-dose computed tomography in the United States-2010 to 2015. JAMA Oncol. 2017 Feb 2. doi: 10.1001/jamaoncol.2016.6416 [Epub ahead of print]
  2. Health coalition forms National Lung Cancer Roundtable to increase screening and reduce lung cancer deaths [news release]. Atlanta, GA: American Cancer Society; March 23, 2017. Accessed April 2017.
  3. Aberle DR, Adams AM, Berg CD, et al; National Lung Screening Trial Research Team. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365:395-409.
  4. Wu GX, Goldstein L, Kim JY, Raz DJ. Proportion of non-small-cell lung cancer patients that would have been eligible for lung cancer screening. Clin Lung Cancer. 2016;17(5):e131-139. doi: 10.1016/j.cllc.2016.01.001

This article originally appeared on Cancer Therapy Advisor