Lung Cancer: Lung Cancer Screening in the Real World |

Effects of a Community Hospital Lung Cancer Screening Program on Patient Wellness: Benefits Go Beyond Early Lung Cancer Detection FREE TO VIEW

Richard Salzano, MD; Nathan Dembowski, BS; Kathleen Chaisson; Christine Marr, MPH
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Griffin Hospital, Derby, CT

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):730A. doi:10.1016/j.chest.2016.08.825
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SESSION TITLE: Lung Cancer Screening in the Real World

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Sunday, October 23, 2016 at 04:30 PM - 05:30 PM

PURPOSE: Early detection of lung cancer through screening with low dose CT (LDCT) has been well documented in large center studies, e.g. ELCAP, with limited stage lung cancer comprising 80% or more of new diagnoses. Little has been written on other effects of screening programs on overall patient wellness, including patient attitudes about lung cancer and effects on smoking habits. We report the results of a community hospital screening program on staging at time of detection, as well as the results of a patient survey on feelings, behaviors, and perceptions as they relate to participation in the program.

METHODS: We reviewed our registry from inception in October 2013 through December 2015. All patients diagnosed with lung cancer in that period were staged and operated on by one surgeon. In addition, we randomly selected 101 patients enrolled from October 2013 through December 2014 for a telephone survey which included questions quantitating anxiety about lung cancer before and after lung cancer screening participation, attitudes on smoking behavior, and general impacts of the screening process.

RESULTS: A total of 514 patients had initial screening scans. Nine patients were diagnosed with lung cancer, all on their initial LDCT. Seven (78%) were limited disease (Stage I or II), and two (22%) were advanced disease (Stage III or IV). In the telephone survey, patients reported a pre-screening mean anxiety level about lung cancer of 4.69 on a scale of 0 (no anxiety) to 10 (very anxious). After screening, the mean anxiety level decreased to 3.87 (p=0.014). No surveyed patients experienced any negative impact from participation, and 95 (94%) described personal benefits from participation. Of the 53 who were current smokers on enrollment, 5 quit smoking after intake into the program, and 30 of the remaining 48 indicate they are more likely to quit as a result of the program.

CONCLUSIONS: Large scale study results of LDCT for lung cancer screening are reproducible at a community level. Patients do benefit from participation beyond early lung cancer detection, with reduced anxiety, no identified negative impact, and positive effects on smoking attitudes.

CLINICAL IMPLICATIONS: This shows that all hospitals, regardless of size or resources, should establish lung cancer screening programs, as the benefits to eligible patients are substantial and multifactorial. Smoking cessation programs must be an integral component of any lung cancer screening program.

DISCLOSURE: The following authors have nothing to disclose: Richard Salzano, Nathan Dembowski, Kathleen Chaisson, Christine Marr

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