Translating New Lung Cancer Screening Guidelines into Practice: The Experience of One Community Hospital

Abstract

Introduction:In December 2013 the US Preventive Services Task Force issued a recommendation for lung cancer screening with annual low-dose computed tomography (LDCT). As screening guidelines emerge and change, this creates an environment for studying the translation of these guidelines into practice. This study assessed how these guidelines were implemented in a community hospital setting and the resulting radiologic findings.Methods: This observational study examined the radiologic outcomes of LDCT lung cancer screening guidelines and the resulting notification.Results: During the first year after publication of the guidelines, 94 screening LDCT scans were ordered. Of these, 21 (22.3%) did not meet the criteria outlined by the US Preventive Services Task Force. Among the 72 cases that did met published criteria, 65.3% of scans detected nodules, and among the remaining 35.6%, half had another clinically significant finding.Discussion: This study shows that new lung cancer screening guidelines, as implemented at a community hospital, resulted in radiologic findings that required follow-up in more than half of patients. Clinicians must be aware of these potential incidental findings when talking to patients about the decision to order screenings. (J Am Board Fam Med 2016;29:152-155.)

Family Medicine Research That Provides Compelling, Urgent Data to Improve Patient Care

“…An excellent review on preexposure prophylaxis for HIV prevention is authored by Conniff and Evensen. 11 Ledford et al 12 investigate the outcome of implementing computed tomography for reducing lung cancer mortality in a community hospital. The multiple articles on patient-centered medical homes [13][14][15][16][17][18][19][20] are separately discussed by Thomas Rosenthal, who wrote the classic patient-centered medical home article, one of the most cited and read articles from the Journal of the American Board of Family Medicine.…”