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L.E. Feldman



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    P2.06 - Poster Session/ Screening and Early Detection (ID 219)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Screening and Early Detection
    • Presentations: 1
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      P2.06-018 - Health Disparities Assessment in a Newly Established Lung Cancer Screening Program (ID 3109)

      09:30 - 09:30  |  Author(s): L.E. Feldman

      • Abstract

      Background:
      Lung cancer incidence and mortality rates differ depending on race, ethnicity, and gender. African American (AA) men have significant higher incidence and mortality from lung cancer compared to white men (incidence 87.3 vs. 72.5; mortality 70.1 vs. 57.8 per 100,000). Lung cancer screening is an effective lifesaving tool. The National Lung Screening Trial (NLST) showed a 20 percent reduction in lung cancer mortality with low-dose computerized tomography (LDCT) versus chest X-ray screening, but the study population was 91% white and only 4.5% AA. Could the reduction in lung cancer mortality be even greater if the NLST population included a larger minority population? UI Health has a large community outreach that serves minority populations in Chicago (48% AA, 24% classified as “other”, 16% White, 7% Hispanic). In March 2015, UI Health began a comprehensive lung cancer-screening program.

      Methods:
      The program coverage and eligibility is broadly advertised to patients and primary practitioners in our community. Previously, low cost lung cancer screening was available but coverage was a concern for patients and practitioners. Lung cancer screening eligibility criteria used is set by the CMS (age 55-77, current smoker or one that have quit within the past 15 years, smoking history of > 30 pack-years) and the U.S. Preventive Services Task Force (including ages up to 80 for non-Medicare patient). American College of Radiology LungRADS system is used for standardized image reporting, and recommended management for positive screens. Data elements include age, gender, race/ethnicity, insurance type, LDCT findings, and treatment modalities for diagnosed lung cancer is collected in a secure registry.

      Results:
      In our first month, 13 patients have been screened between the ages of 56-76, 7 females/6 males. Race/ethnicity make-up: 54% AA, 31% White, 15% Hispanic. Estimated volume of LDCT screens is 200 per year. As yet, there are no significant findings requiring intervention. Of note, in the greater than 2 years that screening was an option but coverage was not clarified by CMS, fewer than 10 patients participated, suggesting that lack of coverage by CMS or commercial carriers was a barrier for our patients.

      Conclusion:
      Coverage by CMS and commercial carriers for LDCT screening has a significant impact on our patient population. Analysis from this study will assess if we can reach a large underserved group with a screening program and whether it will result in decrease of lung cancer mortality in this population.