Improving lung cancer screening: An equitable strategy through a tobacco treatment clinic

Abstract

Annual screening with low dose chest tomography has been adopted for those at high risk to aid in the early detection of lung cancer. In addition to screening, it is recommended that such persons receive evidence-based smoking-cessation. However, both lung cancer screening and evidence-based smoking-cessation strategies are underutilized in the US. We review the impact of a dedicated Tobacco Treatment Clinic (TTC), delivering evidence-based smoking cessation strategies, on lung cancer screening enrollment. Patients of the TTC, aged 50 years or older, having a minimum 20-pack-year smoking history were included. All patients had records reviewed to see if they had received lung cancer screening; if their lung cancer screening was achieved through the TTC, this was documented as “initial screening” versus “continued screening or surveillance”. Sociodemographic variables were collected as well. As for results, between January 2019 to February 2020, 92 patients enrolled in the TTC and fulfilled criteria for lung cancer screening. The mean age was 65.7 ± 8.3 years old, with 58 (63.0%) of the patients being female. Seventy-five (81.5%) patients were African American. Of the 92, 68 (73.9%) patients had lung cancer screening, with 51 patients receiving their first lung cancer screening scan through the TTC. In conclusion, through enrollment in a dedicated TTC, a significant proportion of patients were able to access lung cancer screening for the first time. Further, many of these patients were of minority status. Having a dedicated TTC may improve current health equity gaps in lung cancer screenings in certain US populations.

Tobacco quitline staffs' knowledge and attitudes about connecting quitline callers to lung cancer screening educational materials

“…based upon age and smoking history, to high-quality decision support materials on LCS. 22 We found that the training session significantly improved quitline staffs' knowledge of LCS from baseline, and that quitline staff thought that connecting quitline callers to LCS education was acceptable, feasible, and appropriate. Our findings show that overall, quitline staff had low levels of baseline knowledge of LCS, indicating that there is a need for training about lung cancer and LCS so they can educate quitline callers, particularly about the eligibility criteria and the potential benefits and harms of LCS.…”

“…Tobacco quitlines can play a critical role in connecting quitline callers, many of whom are eligible for LCS based upon age and smoking history, to high‐quality decision support materials on LCS 22 . We found that the training session significantly improved quitline staffs' knowledge of LCS from baseline, and that quitline staff thought that connecting quitline callers to LCS education was acceptable, feasible, and appropriate.…”

Cancer‐Specific health equity metrics in the United States of America: A scoping review

“…Of these 40 articles, the majority addressed cancer screening, with most (n = 13) focusing on reducing inequities in colorectal cancer (CRC) screening. One article addressed lung cancer screening, 19 four articles addressed breast cancer screening with mammography [20][21][22] or sameday biopsy. 23 Seven articles addressed cervical cancer screening [24][25][26][27][28][29] or follow-up colposcopy.…”

“…Overall, outreach by professional healthcare providers and lay educators alike appears to improve screening rates, including minority groups 25,29,30 . In addition, results suggest that strategies designed to increase access to cancer screening can reduce disparities in guideline‐concordant screening 19,23 . However, additional evidence is needed to clarify which strategies are likely to be most effective for building engagement in different communities.…”

Prevalence of Mental Health and Social Connection among Patients Seeking Tobacco Dependence Management: A Pilot Study

“…All patients who attended the Tobacco Treatment and Cancer Screening Clinic (TTCSC), which has been previously described [ 24 ], between January 2021 to December 2021 were screened for potential inclusion. Screening consisted of a member or members of the TTCSC interdisciplinary team reviewing patient charts prior to their clinical appointment.…”