We Know That We Can Reduce Lung Cancer Mortality with Low-Dose CT Screening, but How Do We Make It Work?

Background:

• The National Lung Screening Trial enrolled 53,454 people who were at high risk for lung cancer from August 2002 to April 2004. Data were collected from the lung cancer diagnoses and deaths that occurred from lung cancer through December 21, 2009. Through this study, patients who had a chest x-ray vs a low-dose CT (LDCT) scan proved a reduction in the mortality rate from lung cancer with an LDCT screening of 20%
• Criteria for LDCT include patient-shared decision-making and smoking cessation if appropriate

Objective:

• We know that we can reduce lung cancer mortality with LDCT screening, but how do we make it work? TriStar thoracic navigation team organized community outreach events in Middle Tennessee to educate the senior citizen population about lung cancer risk factors, prevention, and screening in an effort to find early-stage lung cancer

Methods:

• The thoracic navigation team went to 5 locations around Middle Tennessee and spoke with 219 people. We presented an American Cancer Society slide show explaining lung cancer, its causes, prevention, and recommendations for early detection
• Participants were asked to complete a 5-question pretest to assess lung cancer knowledge
• Participants were then asked to complete the same 5 questions to determine effectiveness of presentation
• Participants were provided education/handouts from the American Cancer Society and the Lung Cancer Alliance with information regarding lung cancer, screening, and smoking cessation
• The navigation team was available after the presentation to discuss eligibility and interest for LDCT lung screening

Results:

• Out of the 219 attendees, 99 stated they were very likely to pass along the information learned to someone else, and 23 stated they were eligible and would like additional information about LDCT screening. However, none of the 23 attendees followed through with the LDCT screening. Despite navigators being available to discuss and help facilitate LDCT screening, no one took advantage of the opportunity. The attendees failed to leave identifying information on their forms for navigator follow-up afterward.

Conclusion:

• While no LDCT screenings were completed based on the participants at this outreach, there was a strong response to the survey question asking “how likely” they were to share what they learned with others who smoke and/or have other risk factors for lung cancer
• The targeted audience of this presentation in majority were found to be outside the screening age and in fairly good health as they participate in the Silver Sneakers program on a regular basis
• In the future, the target audience could include more outreach to the high-risk population
• Future outreach would include a comprehensive health fair to include registration, shared decision-making clinic, and on-site LDCT screening. The lung nodule coordinator would follow up on all Lung Rad 3s and 4s, and patients who were diagnosed with lung cancer would be transferred to the thoracic nurse navigator for continuum of care.