Lung Cancer Screening: A Population Approach

✍ Scribed by Gregory C. Kane (editor), Julie A. Barta (editor), Ronald E. Myers (editor), Nathaniel R. Evans III (editor)

• Publisher: Springer
• Year: 2023
• Tongue: English
• Leaves: 388
• Category: Library

✦ Synopsis

This book is a comprehensive guide to lung cancer screening for clinicians, healthcare systems, community leaders, and public health officials with the hope of creating a more equitable landscape in both lung cancer screening and lung cancer-related outcomes, at local, state, and national levels. Authors take a new approach to primary and secondary lung cancer prevention that is in the early stages of adoption in the United States. The last decade ushered in recognition of screening as an effective intervention, but unfortunately, despite the wide acceptance of the importance of this new screening modality, nationally, not more than 5% of eligible subjects have undergone screening to date in the United States, although in some states uptake has reached as high as 16%. As is common with any new preventive cancer screening, racial and socioeconomic disparities emerge in utilization, stage at diagnosis, and mortality. Over time, these disparities decline, but consequential differences endure. Therefore, it is critical to establish equitable screening practices.

The true measure of the effectiveness of any lung cancer screening program needs to be viewed through the lens of its impact on populations, including those most affected by the morbidity and mortality of smoking-related illness and lung cancer. As such, this book emphasizes a number of important public health topics, including community outreach to vulnerable populations, social justice issues, addressing stigma and fatalism in the general community, and the use of geocoding to assess a program’s impact at a population level. This book weaves traditional topics related to lung cancer screening, such as promoting initial and repeat screening, interpreting Lung RADs, and managing the follow-up of findings, into the population perspective in order to present a unified, comprehensive approach to the subject. Further, it serves as a guide that health systems, health care professionals, community leaders, and other stakeholders can use to achieve the promise of lung cancer screening.

✦ Table of Contents

Foreword
Contents
Contributors
Part I: Introduction
Chapter 1: The Promise of Lung Cancer Screening
Background
Causes of Lung Cancer
The Tools of Modern Medicine Are Coming Together
Overcoming Barriers
Realizing the Promise of Lung Cancer Screening
References
Chapter 2: A Brief History of Lung Cancer Screening
Background
Lung Cancer Screening by Chest X-Ray and Sputum Cytology
Lung Cancer Screening by CT Scan: Initial Studies
Nelson and Beyond
Conclusion
References
Chapter 3: Stigma and Fatalism in Lung Cancer
Stigma
Stigma Definition and Background
Stigma in Lung Cancer
Measuring Stigma
Consequences of Stigma
Delayed Presentation and Avoidance of Treatment
Quality of Life
Depression/Anxiety/Psychological Distress
Interventions to Reduce Stigma
Conclusions
Fatalism
References
Chapter 4: Training in Shared Decision Making About Lung Cancer Screening: Patient Eligibility Assessment, Education, and Decision Counseling
Background
The Need for Training in Shared Decision Making About Lung Cancer Screening
Developing a Lung Cancer Screening Shared Decision-Making Training Program
Evaluating SDM Quality
Disseminating the Lung Cancer Screening SDM Training Program
Conclusion
References
Chapter 5: Smoking Cessation in a Lung Cancer Screening Program
Background
Nicotine and Tobacco
Chemicals in Cigarettes
Chemicals in Other Tobacco Products
Biological Basis of Nicotine Dependence
Cognitive Management of Dependence
Nicotine Replacement Therapies
Lung Cancer and Smoking
Smoking Cessation Within a Lung Cancer Screening Program
Conclusion
References
Chapter 6: Why Health Equity Is So Important in Lung Cancer Screening?
References
Part II: Applying a Learning Community Model
Chapter 7: Engaging a Health System Learning Community to Increase Lung Cancer Screening
Background
A Model to Guide Formation of a Health System Learning Community
Aim 1: Engaging Patients, Providers, and Stakeholders.
Aim 2. Identifying Effective Interventions.
Aim 3. Catalyzing Support for Collaborative Action
Aim 4. Evaluating Engagement Among Members of the Learning Community
Conclusion
References
Chapter 8: Different Approaches for Offering Lung Cancer Screening
Background
Components of a High-Quality Lung Cancer Screening Program
Centralized Model
Decentralized and Hybrid Models
Role of Patient Care Coordinators or Patient Navigators
Integration of Smoking Cessation Interventions
Determining the Best Approach to Offer Lung Cancer Screening
Conclusion
References
Chapter 9: Enhancing EMR Methods to Identify Patients Eligible for Lung Cancer Screening
Background
Background
Methods
Results
Conclusion
References
Chapter 10: Primary Care Provider Support and Patient Outreach in Lung Cancer Screening
Background
Supporting Primary Care Providers
Outreach to Primary Care Patients
Conclusion
References
Chapter 11: Shared Decision Making in the Lung Cancer Screening Context
Background
What Is Shared Decision Making?
Shared Decision-Making Frameworks
Decision Aids or Decision Support Tools
Challenges to Implementing Shared Decision Making in the Lung Cancer Screening Context
Supporting Implementation of Shared Decision Making in the Lung Cancer Screening Context
Conclusions
References
Chapter 12: Advances in Tobacco Treatment
References
Part III: Organizing a Quality Program
Chapter 13: Organizational Workflow for Lung Cancer Screening
Background
Planning for Implementation of a Lung Cancer Screening Program
The Centralized Model
Multidisciplinary Teams in Lung Cancer Screening
Tracking Data and Quality Metrics
Conclusions
References
Chapter 14: Lung-RADS® and Radiology Reporting Requirements
Background
Lung-RADS®
Comparison of Fleischner and NLST Criteria
Lung-RADS® Version 1.0
Lung-RADS® Versions
Lung-RADS® Performance
Lung-RADS® Limitations
Imaging Facility and Physician Requirements
Conclusion
References
Chapter 15: Managing Incidental Findings
Background
Lung Cancer Screening
Incidental Findings
Types of Incidental Findings
Incidental Findings and Follow-up Testing
Reporting Incidental Findings on LCS, “S” Modifier
Common IFs on LDCT
Managing Incidental Findings in Centralized LCS Program
Multidisciplinary Team Approach
Conclusion
References
Chapter 16: Leveraging the Electronic Health Record for Continuous Quality
Background
Screening Guidelines and Coverage
EHRs and Quality Metrics
Identification of Patients for Screening
Shared Decision Making and Smoking Cessation Counseling
Screening, Results, and Follow-up
Reporting and Maintaining Quality
Conclusions
References
Chapter 17: Minimizing Harms of Screening
Background
Lung Cancer Screening
Potential Harms of Lung Cancer Screening
Overdiagnosis
False Positive Results
Radiation Exposure
Economic and Psychological Impact
Minimizing the Risks of Lung Cancer Screening
Need for a Validated Risk Predictive Calculator
Shared Decision Making
A Multidisciplinary Team Approach
Conclusion
References
Chapter 18: A Multidisciplinary Approach
Organizing a Multidisciplinary Team
Strengths of a Multidisciplinary Team
Determining Optimal Management Strategy
Maximizing Efficiency
Quality Improvement
Conclusion
References
Chapter 19: Managing Lung Cancer Screening in a Major Healthcare System
Background
Choosing the Appropriate Guideline
Establishing Lung Cancer Screening Champions
Need for Radiology Equipment and Support
Creating the Multidisciplinary Pulmonary Nodule Review Board
The Nodule Review Board’s Procedural Capabilities
Should Screening Be Centralized?
The Role of the Electronic Health Record and Nodule Tracking
Creating the Pulmonary Nodule Clinic and Team
Patient Education and Resources
LCS Outreach and Publicity
Adhering to Societal Guidelines and Reimbursements
References
Chapter 20: Cost Considerations
References
Part IV: Taking Care of the Patient
Chapter 21: Using Health Literacy Principles to Engage Patients from Diverse Backgrounds in Lung Cancer Screening
Background
Health Literacy Overview
Integrating Health Literacy into Health Care Systems
Personal Health Literacy: Communication Strategies
Health Literacy Strategies in Interpersonal Communication
Language Assistance
Using a Health Literacy Lens to Develop and Improve Written Health Materials
Organizational Health Literacy and Lung Cancer Screening
Conclusion
References
Chapter 22: Local Therapy for Early-Stage Lung Cancer
Surgical Therapy to Early-Stage Lung Cancer
The Evolution of Surgical Procedures for Lung Cancer
Screen Detected Lung Cancers
Surgical Approach to Lung Cancer Surgery
Outcomes After Lung Cancer Surgery
Challenges in Lung Cancer Surgery
Surgical Candidacy and Alternatives to Surgery
Stereotactic Body Radiation Therapy (SBRT) for Treatment of Early-Stage Lung Cancer
References
Chapter 23: The Revolution of Lung Cancer Therapeutics
Background
Non-small Cell Lung Cancer
Small Cell Lung Cancer
Conclusions and Future Directions
References
Part V: Engaging the Community
Chapter 24: Lung Cancer and Social Justice: What Do I Need to Know?
Medical Apartheid, by Harriet Washington, MA
Caste, by Isabel Wilkerson
How the Word Is Passed, by Clint Smith, PhD
Fatal Invention, by Dorothy Roberts, JD
Across that Bridge, by John Lewis
When Can We Go Back to America?, by Susan Kamei, JD
Tattoos on the Heart, by Greg Boyle, MA, MDiv, STM
What the Eyes Can’t See, by Mona Hanna-Attisha, MD, MPH
Our America: A Hispanic History of the United States, by Filipe Fernandez-Armesto, D Phil
Walking the Trail: One Man’s Journey Along the Cherokee Trail of Tears, by Jerry Ellis
Black on Both Sides: A Racial History of Trans Identity, by C. Riley Snorton, PhD
As Long as Grass Grows, by Dina Gilio-Whitaker, MA
Empathic Listening as a Tool to Understand Our Patients
References
Chapter 25: Reaching Vulnerable Populations and Areas of Need
Background
Health Literate Care Model
National Institutes of Health (NIH) Clear & Simple Strategy and Community-Based Participatory Research
Step One: Define the Intended Audience
Step Two: Conduct Research
Research Methods
Step Three: Develop a Concept for the Product
Step Four: Develop Content and Visuals
Step Five: Pretest and Revise
Current Progress and Community Outreach
Next Steps
References
Chapter 26: Lung Cancer Myths and How Do I Address Them?
Background
The Myths
Myth One: “Only Smokers Get Lung Cancer”
Myth Two: “Vaping Is a Safe Alternative to Smoking”
Myth Three: “If You Get Lung Cancer From Smoking, It Is Your Own Fault”
Myth Four: “There’s No Way To Detect Lung Cancer Early”
Myth Five: “If I Am in a Screening Program, There Is No Reason to Stop Smoking”
Myth Six: “If You Already Have Lung Cancer, There Is No Reason To Stop Smoking”
Myth Seven: “Surgery Causes Lung Cancer To Spread”
Myth Eight: “Surgery for Lung Cancer Requires a Long Recovery Period”
Myth Nine: “I Am Too Old to Benefit from Treatment for Lung Cancer”
Myth Ten: “Lung Cancer Is a Death Sentence”
Addressing Lung Cancer Myths
Step One: Have a Forward-Leaning Posture Related to Misperceptions and Myths
Step Two: Fully Appreciate the Complexity of Physician–Patient Communication
Step Three: Ensure Available Information Is Properly Designed for Your Target Population
Step Four: Build a Team That Is Culturally Accessible to a Diverse Patient Population
Step Five: Make Space for Patients to Ask Questions About Myths and Misperceptions That They Feel Otherwise Feel Uncomfortable Raising
Step Six: Continue the Conversation
References
Chapter 27: Achieving Health Equity in Lung Cancer Screening: Incorporation of Community Perspectives for Maximum Impact
Background
Underutilization of Lung Cancer Screening as a Critical Quality Gap
Provider-Specific Considerations
Patient-Facing Concerns
Using Dissemination and Implementation Science to Measure the Process and Impact of Efforts to Increase Lung Cancer Screening
Final Thoughts
References
Part VI: Determining Impact at the Population Level
Chapter 28: Lung Cancer Screening: Addressing Disparities
Background
Lung Cancer Screening Eligibility
Lung Cancer Screening Uptake
Adherence to Follow-Up
Treatment
Lung Cancer Outcomes and Mortality
Working Toward Equity
References
Chapter 29: Connecting the Dots: Geocoding and Assessing a Program’s Impact
Background
Identifying Geographic Distribution of Disease
Geocoding for Cancer Control
Process of Geocoding
Geocoding Quality and Match Rate
Confidentiality and Privacy
Geographic Patterns and Mapping
Choropleth Maps
Dot Density Maps
Maps with Graduated Symbology Maps
Maps with Proportional Symbology
Point and Kernel Density Maps for Clustering
Hot Spot Analysis and Heat Maps to Express Continuous Variables
Time-Series Maps
Geographic Targeting for Community-Based Interventions
Geocoding and Assessing a Program’s Impact
Note
References
Chapter 30: The Essential Ingredient of Partnership: The Bristol Myers Squibb Foundation’s Collaboration Focused Approach to Health Equity and Lung Cancer Screening
A Mission Rooted in the Power of Partnerships
Co-Developing Solutions in Lung Health Through Clinic–Community Partnerships
Leveraging Best Practices Through a Learning Collaborative Network
More Than Funding to Sustain Partnerships, Services, and Outcomes
Lessons in Fostering Partnership for Funders
References
Part VII: On the Horizon: What Lies Ahead in Lung Cancer Screening
Chapter 31: Lung Cancer Screening in Health Systems: Needs, Challenges, and Opportunities
Background
Lung Cancer Screening Process and Existing Care Models
LCS Use in Current Practice
Enhancing LCS Program Implementation in Health Systems
Implementation Challenges and Opportunities
Conclusions
References
Chapter 32: Across the Landscape: Community-Based Partnerships for Lung Cancer Risk Reduction—From Federal Initiatives to Local Influences
Background
Community Partnerships as a Cancer Risk-Reduction Strategy: Rationale
Community Partnerships for Lung Cancer Risk-Reduction
National Cancer Institute
Legislative Partnerships: Advocacy and Policy
Messaging and Marketing Partnerships
School-Based Partnerships
Workplace Partnerships
Home-Based Partnerships
Peer-Led Partnerships
Community Partnerships for Lung Cancer Early Detection
Lung Cancer Screening
Community Partnerships: Principles
Conclusion
References
Chapter 33: Where Do We Go from Here?
Background
Optimizing Selection Criteria for Lung Cancer Screening
Leveraging Technology for High-Quality Lung Cancer Screening
Expanding Implementation Strategies for Lung Cancer Screening
Conclusion
References
Chapter 34: Imagining an Equitable Lung Cancer Screening Landscape
Imagining the Following
Equity in the Conduct of Screening and Follow-Up
References
Index