News | Lung Cancer | June 18, 2018

Report Finds Identifying Patients for Lung Cancer Screening Not So Simple

Demonstration project discovers information gaps in EHRs that prevent identification of those patients who would most benefit from screening

Report Finds Identifying Patients for Lung Cancer Screening Not So Simple

June 18, 2018 — New findings in the current issue of The American Journal of Managed Care suggest that getting the right patients to participate in low-dose computed tomography (LDCT) lung cancer screening is more difficult than expected under the Affordable Care Act.

Lung cancer screening is free under the ACA for certain current and former smokers, after a national study found their risk of cancer death fell 20 percent through annual screening with LDCT instead of chest X-rays.

The authors reported on a demonstration project among current and former smokers who were screened in the Minneapolis Veterans Affairs Health Care System. Among their findings:

  • Electronic health records (EHRs) do not always record information about patient tobacco pack-years, a key piece of information needed to gauge eligibility for screening;
  • Of 6,133 potentially eligible patients, 1,388 had available tobacco pack-year information. Of this group, 918 were invited for lung cancer screening and 178, or 19 percent, completed screening;
  • Giving patients a phone call in addition to outreach through the mail made a difference: Twenty-two percent of those with a phone call were screened, compared with 9 percent who only had contact by mail;
  • Among those who completed LDCT, 61 percent had lung nodules requiring follow-up; 12 patients needed more diagnostic evaluation, and two had lung malignancies; and
  • There were 179 “incidental” findings among 116 patients, and 20 percent were clinically significant.

The research sheds light on the challenges of getting the large pool of potentially eligible current and former smokers through the annual screening process. Just 1.9 percent of eligible smokers were screened in 2016, according to data presented in early June at the American Society of Clinical Oncology.

Criteria from the U.S. Preventive Services Task Force (USPSTF) call for screening smokers age 55 to 80 who have smoked at least 30 pack-years, or those with that history who have quit within the past 15 years. Thus, the authors note, getting patients screened requires that health systems have the capacity to capture patient information and track down those who meet the criteria. Health systems also must handle patients who may experience anxiety after a nodule is found, even if it is unlikely to become cancerous.

“Important considerations in lung cancer screening are accurate identification of eligible patients, balancing invitation approaches with resource constraints, and establishing standardized methods for tracking numerous small lung nodules and incidental findings detected by LDCT,” the authors conclude.

“Lung cancer screening implementation presents unique challenges, but they are not insurmountable. With more research and experience, we will find the best method to deliver this important cancer screening intervention to the millions of Americans that need it,” said Angela E. Fabbrini, MPH, lead author and director of the lung cancer screen program in the Minneapolis Veterans Administration Health Care System.

For more information: www.ajmc.com

Related Content

FDA Clears GE's Deep Learning Image Reconstruction Engine
Technology | Computed Tomography (CT) | April 19, 2019
GE Healthcare has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) of its Deep Learning Image...
Artificial Intelligence Performs As Well As Experienced Radiologists in Detecting Prostate Cancer
News | Artificial Intelligence | April 18, 2019
University of California Los Angeles (UCLA) researchers have developed a new artificial intelligence (AI) system to...
Videos | Breast Imaging | April 18, 2019
In a keynote lecture at the Society of Breast Imaging (SBI)/American College of Radiology (ACR) 2019 Symposium, ...
Surgically Guided Brachytherapy Improves Outcomes for Intracranial Neoplasms
News | Brachytherapy Systems | April 18, 2019
Peter Nakaji, M.D., FAANS, general practice neurosurgeon at Barrow Neurological Institute, presented new research on...
Oxipit Introduces Multilingual Support for ChestEye AI Imaging Suite
News | Artificial Intelligence | April 16, 2019
The CE-certified ChestEye artificial intelligence (AI) imaging suite by Oxipit is now available in seven European...
Check-Cap Initiates U.S. Pilot Study of C-Scan for Colorectal Cancer Screening
News | Colonoscopy Systems | April 15, 2019
Check-Cap Ltd. has initiated its U.S. pilot study of the C-Scan system for prevention of colorectal cancer through...
Deep Lens Closes Series A Financing for Digital AI Pathology Platform
News | Digital Pathology | April 09, 2019
Digital pathology company Deep Lens Inc. announced the closing of a $14 million Series A financing that will further...
Enlitic Closes Series B Funding for Artificial Intelligence Solutions for Radiologists
News | Artificial Intelligence | April 08, 2019
Radiology artificial intelligence (AI) company Enlitic announced the close of its $15 million Series B financing round...
Uterine Fibroid Embolization Safer and as Effective as Surgical Treatment
News | Interventional Radiology | April 05, 2019
Uterine fibroid embolization (UFE) effectively treats uterine fibroids with fewer post-procedure complications compared...
Videos | RSNA | April 03, 2019
ITN Editor Dave Fornell takes a tour of some of the most interesting new medical imaging technologies displa