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Erkmen CP , Dako F , Moore R , Dass C , Weiner MG , Kaiser LR , Ma GX
Adherence to annual lung cancer screening with low-dose CT scan in a diverse population
Cancer Causes Control. 2021 Mar;32(3) :291-298
PMID: 33394208    PMCID: PMC7878339   
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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.
Notes
1573-7225 Erkmen, Cherie P Dako, Farouk Moore, Ryan Dass, Chandra Weiner, Mark G Kaiser, Larry R Ma, Grace X U54 CA221704/CA/NCI NIH HHS/United States U54 CA221705/CA/NCI NIH HHS/United States U54 CA221704(5)/CA/NCI NIH HHS/United States Journal Article Cancer Causes Control. 2021 Mar;32(3):291-298. doi: 10.1007/s10552-020-01383-0. Epub 2021 Jan 4.