Adherence to annual lung cancer screening with low-dose CT scan in a diverse population

Cherie P. Erkmen, Farouk Dako, Ryan Moore, Chandra Dass, Mark G. Weiner, Larry R. Kaiser, Grace X. Ma

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Purpose: Our aim was to develop a novel approach for lung cancer screening among a diverse population that integrates the Centers for Medicare and Medicaid Services (CMS) recommended components including shared decision making (SDM), low-dose CT (LDCT), reporting of results in a standardized format, smoking cessation, and arrangement of follow-up care. Methods: Between October of 2015 and March of 2018, we enrolled patients, gathered data on demographics, delivery of SDM, reporting of LDCT results using Lung-RADS, discussion of results, and smoking cessation counseling. We measured adherence to follow-up care, cancer diagnosis, cancer treatment, and smoking cessation at 2 years after initial LDCT. Results: We enrolled 505 patients who were 57% African American, 30% Caucasian, 13% Hispanic, < 1% Asian, and 61% were active smokers. All participants participated in SDM, 88.1% used a decision aid, and 96.1% proceeded with LDCT. Of 496 completing LDCT, all received a discussion about results and follow-up recommendations. Overall, 12.9% had Lung-RADS 3 or 4, and 3.2% were diagnosed with lung cancer resulting in a false-positive rate of 10.7%. All 48 patients with positive screens but no cancer diagnosis adhered to follow-up care at 1 year, but only 35.4% adhered to recommended follow-up care at 2 years. The annual follow-up for patients with negative lung cancer screening results (Lung-RADS 1 and 2) was only 23.7% after one year and 2.8% after 2 years. All active smokers received smoking cessation counseling, but only 11% quit smoking. Conclusion: The findings show that an integrated lung cancer screening program can be safely implemented in a diverse population, but adherence to annual screening is poor.

Original languageEnglish
Pages (from-to)291-298
Number of pages8
JournalCancer Causes and Control
Volume32
Issue number3
DOIs
StatePublished - Feb 2021

Keywords

  • Aged
  • Early Detection of Cancer/methods
  • Female
  • Humans
  • Lung Neoplasms/diagnostic imaging
  • Male
  • Mass Screening/methods
  • Medicare
  • Middle Aged
  • Patient Compliance/statistics & numerical data
  • Smoking Cessation
  • Smoking/adverse effects
  • Tomography, X-Ray Computed/methods
  • United States

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