John Handy, M.D., director, Thoracic Surgery Program, and co-medical director, Thoracic Oncology Program, Providence Cancer Institute
Family physicians are crucial partners in the battle against lung cancer. A newly published study reviewing the care of thousands of Providence patients underscores the benefit of primary care physicians helping their at-risk patients understand the need for, and undergoing, lung cancer screenings that use low-dose CT scans.
Providence Cancer Institute researchers recently published “Results of Lung Cancer Screening in the Community” in Annals of Family Medicine. The paper confirmed that a coordinated multidisciplinary care team approach, including family medicine providers, increases early detection and better outcomes for patients with lung cancer.
More than 228,000 people a year are diagnosed with lung cancer in the United States. Lung cancer is the leading cancer killer in both men and women in the U.S.
Cancer screening helps to identify early, curable cancer prior to any symptoms. Family practice providers are a key partner in the effort to diagnose lung cancer early. This was affirmed in an editorial response to the study by Mayo Clinic clinical epidemiologist Chyke A. Doubeni, M.B.B.S., MPH, and colleagues.
Different types of screening have been tried for decades without success. This new research, as published in Annals of Family Medicine, validates that low-dose CT screening is effective.
In 2011 the National Lung Screen Trial, or NLST, demonstrated for the first time a large decrease in lung cancer deaths if screening is performed in a high-risk population (those with substantial cigarette smoke exposure). This report led the U.S. Preventive Services Task Force to recommend low-dose CT lung cancer screening for people at high risk. However, until now it was uncertain whether these results could be replicated outside of the NLST.
This uncertainty led our Providence Cancer Institute thoracic oncology team to examine data related to lung cancer screenings we conduct for our patients and within the community. The study involved more than 4,600 patients in the Portland metro area during a five-year period. Of those, about 3,400 underwent an initial lung cancer screen, and 500 then went on to receive additional imaging. In some cases, invasive interventions included diagnostic procedures or surgeries.
Screening resulted in 95 lung cancers diagnosed, the majority being stage 1. The findings underscore the NLST results leading to the initial recommendation of lung cancer screenings for people at high risk.
Study researchers noted that lung cancer screening benefits outweigh potential harm and that family provider engagement is integral. The “window of net benefit” depends on a number of factors in the screening and treatment process, including “quality of CT images and quality of interpretation, disease prevalence in the population, patient health status, and the timeliness, safety, and effectiveness of treatment for abnormal screening results,” wrote Dr. Doubeni and colleagues.
“Family medicine is critical for increasing the reach of lung cancer screenings” and primary care is an “ideal setting to improve access to screenings, particularly for underserved populations,” concluded the Mayo Clinic editorial. Therefore, family physicians should be engaged and equipped with guidance on best practices in lung cancer screenings and referrals.
“Results of Lung Cancer Screening in the Community,” was authored by Handy; Michael Skokan, M.D., The Oregon Clinic and Providence Cancer Institute Lung Cancer Screening co-medical director; Erika Rauch, Providence Cancer Institute Lung Cancer Screening program coordinator; Steven Zinck, M.D., The Radiology Group and Providence Cancer Institute Thoracic Oncology Program; Rachel Sanborn, M.D., Providence Cancer Institute Thoracic Oncology co-medical director; Svetlana Kotova, M.D., Providence Cancer Institute Thoracic Oncology Program; and Mansen Wang, Providence biostatistician.
For more information:
Dr. Rachel Sanborn on KATU:
Southern Oregon: 541-732-5082
Northern Oregon: 971-358-6859
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