Study Demonstrates Logistical Challenges and Potentially Harmful Results in Lung Cancer Screenings

Performing Lung cancer screening on high-risk patients with low-dose computed tomography (CT) presents logistical challenges and potentially harmful results, says a new study from the Lung Cancer Screening Demonstration Project.

Researchers surveyed more than 93,000 primary care patients for lung cancer screening criteria at eight Veterans Health Administration facilities across the country. Out of that group, 2,106 were between the ages of 55 and 80 years-old, current or former heavy smokers, and had received lung cancer screening between July 2014 and June 2015. Out of those patients, 1,257 (59.7 percent) had nodules, and 1,184, (56.2 percent) required tracking, and 42 (2 percent) needed further evaluation, and 31 (1.5 percent) were diagnosed with lung cancer.

Linda S. Kinsinger, M.D., M.P.H., retired director of the VHA National Center for Health Promotion and Disease Prevention, VHA radiologist Charles Anderson, MD, PhD, and internist Jane Kim, MD, MPH, authored the study recently published in January in JAMA Internal Medicine. The determined that despite VHA facilities’ sophisticated electronic medical records, developing electronic tools to capture sufficient clinical data to meet the needs of lung cancer screening administrators was a challenge, according to the study.

 "The VHA LCSDP [Lung Cancer Screening Demonstration Project] found implementing a comprehensive LCS [Lung Cancer Screening] program that followed recommendations to be challenging and complex, requiring new tools and patient care processes for staff as well as dedicated patient coordination," the authors wrote.

 These results have prompted the VHA to plan for a more expansive LCS program across its health care system. These findings will likely influence other screening programs to develop more comprehensive components for their surveys.