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A.Z. Dudek
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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
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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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): A.Z. Dudek
- 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.
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P3.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 208)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.01-060 - Prognostic Value of Serum Proteomic Test and of Comorbidity Index in Diversified Population with Lung Cancer (ID 1597)
09:30 - 09:30 | Author(s): A.Z. Dudek
- Abstract
Background:
Proteomic (VeriStrat®) serum test has prognostic and predictive value in response to erlotinib; but the relation between comorbidity index and test performance and usefulness of this test in different races has not been adequately studied yet.
Methods:
Patients and Methods: We have reviewed electronic records of lung cancer patients from 09/2009 till 07/2014who had proteomic test performed to help with therapy choice. Extracted data was analyzed for survival using SAS software 9.4.
Results:
Among 49 qualified patients, 31 had VeriStrat® test done before and 18 after the first line treatment for metastatic disease. Nineteen cases with good VeriStrat® (VSG) test received erlotinib, and 12 received chemotherapy; 4 cases with VeriStrat® poor (VSP) results received erlotinib and 12 received chemotherapy. When stratified for test results “VSG vs. VSP” overall survival did not differ between white race and other races (HR=1.005; 95%CI=0.43-2.35; p=0.99). There was a trend of better survival for combined effect of VeriStrat® good test (VSG) and African American (AA) race. Patients with VSG test had better survival than patients with VSP test in each Charlson comorbidity index (CCI) stratum.
Conclusion:
Our study shows that there is no significant impact of race on prognostic and predictive values of VeriStrat® test. Prognostic value of this test is independent of comorbidities and older age.
