A quality improvement project was designed to facilitate identifying people who are eligible for lung cancer screening. The project was described in a poster presentation on the ONS Bridge, a virtual conference.1

Based on findings from the landmark, randomized National Lung Cancer Screening Trial (NLCST), as well as other level 1 evidence, the US Preventive Services Task Force (USPSTF) issued recommendations for the use of low-dose computed tomography (LDCT) to screen persons considered to be at high risk of lung cancer according to prespecified criteria.2,3

Nevertheless, reports indicate that less than 2% of persons in the US who meet USPSTF guideline-based criteria for lung cancer screening actually underwent screening LDCT in 2016.4 Hence, these results highlight a need for programs that raise awareness about lung cancer screening in community health and primary care settings.

To facilitate identification of patients eligible for lung cancer screening in these settings, a simple decision tool was developed to evaluate lung cancer risk, consisting of 3 simple questions for patients to determine their eligibility for LDCT lung cancer screening:


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  • Are you between 55 and 77 years of age?
  • Do you have a smoking history corresponding to at least 30-pack years?
  • Are you a current smoker or have you quit smoking within the last 15 years?

In commenting on this decision tool, Cynthia Howard, DNP, of Baptist Health in Jacksonville, Florida, author of the poster presentation, stated that “understanding the criteria for lung cancer screening can help nurses and advanced practice nurses facilitate patient education and provide patients with resources for lung cancer screening.”

Also reported were the results of a study evaluating outcomes of persons at high risk for lung cancer who were referred for and underwent LDCT lung cancer screening at a comprehensive cancer center.

Of the 485 participants who underwent lung cancer screening over a 3-month period, LDCT findings were categorized as negative, probably benign, and requiring additional testing in 74%, 5%, and 8%, respectively. Of the 39 patients included in the latter category, stage I/II, stage III, and stage IV lung cancer were diagnosed in 6, 1, and 1 participant(s), respectively.

“Lung cancer screening with [LDCT] detects lung cancer in earlier stages and reduces mortality,” Dr Howard emphasized in her closing remarks.

References

  1. Howard C. Lung cancer screening. Presented at: ONS Bridge; September 8-17, 2020. Accessed September 4, 2020. https://ons.confex.com/ons/2020/ap/eposter.cgi?eposterid=1049
  2. National Lung Screening Trial Research Team; Aberle DR, Adams AM, Berg CD, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365(5):395-409. doi:10.1056/NEJMoa1102873
  3. U.S. Preventive Services Task Force. Final recommendation statement. Lung cancer: screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening. Accessed September 8, 2020.
  4. Pham D, Bhandari S, Oechsli M, Pinkston CM, Kloecker GH. Lung cancer screening rates: data from the lung cancer screening registry. J Clin Oncol. 2018;36(15_suppl):Abstract 6504.

This article originally appeared on Oncology Nurse Advisor