Comparison of Underlying Risk of Developing and Dying from Lung Cancer in Screened Populations.

Background: Trial participants are typically healthier than the general population. Differences in underlying characteristics between the population undergoing lung cancer screening (LCS) and LCS trial participants may alter the benefits of LCS.

Research Question: Does the risk of developing and dying from lung cancer differ between trial participants and the general population?

Study Design And Methods: Using data from the i) North Carolina Lung Screening Registry (NCLSR), ii) 2022 Center for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS) Lung Cancer Screening Module, and iii) National Lung Screening Trial (NLST), we estimated the 5-year probability of developing and dying from lung cancer if not screened using publicly available macros.

The United States' Early Experience With Lung Cancer Screening-Creation of a National Data Linkage: A Brief Report.

Introduction: Lung cancer screening has been recommended by the United States Preventive Services Taskforce since 2013. The Centers for Medicare and Medicaid Services coverage decision in early 2015 required data submission to a Centers for Medicare and Medicaid Services-approved registry for facilities to receive payment for screening. Only the American College of Radiology's Lung Cancer Screening Registry (LCSR) received approval for this purpose.

Comparing characteristics of individuals screened for lung cancer with 2021 vs 2013 US Preventive Services Task Force recommendations.

We conducted a cross-sectional, multicenter study to compare the demographics, clinical characteristics, and lung cancer screening results among individuals eligible for lung cancer screening per 2013 vs 2021 US Preventive Services Task Force recommendations. Statistical tests are 2 sided, with P less than  .05 considered statistically significant.

Receipt of Recommended Follow-up Care After a Positive Lung Cancer Screening Examination.

Importance: Maximizing benefits of lung cancer screening requires timely follow-up after a positive screening test. The American College of Radiology (ACR) Lung CT Screening Reporting and Data System (Lung-RADS) recommends testing and follow-up timing based on the screening result.

Objective: To determine rates of and factors associated with recommended follow-up after a positive lung cancer screening examination by Lung-RADS category.

Breast cancer incidence among women with a family history of breast cancer by relative's age at diagnosis.

Background: Women with a first-degree family history of breast cancer are often advised to begin screening when they are 10 years younger than the age at which their relative was diagnosed. Evidence is lacking to determine how much earlier they should begin.

Methods: Using Breast Cancer Surveillance Consortium data on screening mammograms from 1996 to 2016, the authors constructed a cohort of 306,147 women 30-59 years of age with information on first-degree family history of breast cancer and relative's age at diagnosis.

Decision quality and regret with treatment decisions in women with breast cancer: Pre-operative breast MRI and breast density.

Purpose: We evaluated self-report of decision quality and regret with breast cancer surgical treatment by pre-operative breast MRI use in women recently diagnosed with breast cancer.

Methods: We conducted a survey with 957 women aged 18 + with stage 0-III breast cancer identified in the Breast Cancer Surveillance Consortium. Participants self-reported receipt of pre-operative breast MRI.

Characterization of older adults with cancer seeking acute emergency department care: A prospective observational study.

Introduction: Disparities in care of older adults in cancer treatment trials and emergency department (ED) use exist. This report provides a baseline description of older adults ≥65 years old who present to the ED with active cancer.

Materials And Methods: Planned secondary analysis of the Comprehensive Oncologic Emergencies Research Network observational ED cohort study sponsored by the National Cancer Institute.

Palliative Care Needs and Clinical Outcomes of Patients with Advanced Cancer in the Emergency Department.

Older adults with cancer use the emergency department (ED) for acute concerns. Characterize the palliative care needs and clinical outcomes of advanced cancer patients in the ED. A planned secondary data analysis of the Comprehensive Oncologic Emergencies Research Network (CONCERN) data.

Prospective Multisite Cohort Study to Evaluate Shared Decision-Making Utilization Among Individuals Screened for Lung Cancer.

Purpose: The aim of this study was to determine the frequency, components of, and factors associated with shared decision-making (SDM) discussions according to electronic health record (EHR) documentation among individuals undergoing lung cancer screening (LCS).

Methods: A prospective observational cohort study was conducted of individuals undergoing LCS between February 2015 and June 2020 at four LCS centers. The primary outcome was EHR-documented SDM, defined using Medicare-designated components.

Randomized control trial of unconditional versus conditional incentives to increase study enrollment rates in participants at increased risk of lung cancer.

Introduction: Understanding how incentives and their timing influence study enrollment rates is important to efficient study design and increasing the generalizability of findings. This 2-arm, parallel randomized trial evaluated how conditional vs. unconditional mailed incentives of a $20 gift card affected study enrollment in a sample of participants screened for lung cancer screening.

Molecular Biomarker and Programmed Death-Ligand 1 Expression Testing in Patients With Advanced Stage Non-small Cell Lung Cancer Across North Carolina Community Hospitals.

Background: Precision medicine in advanced non-small cell lung cancer (NSCLC) requires molecular biomarker testing in patients with nonsquamous and select patients with squamous histologies, and programmed death-ligand 1 (PD-L1) testing in both.

Research Question: What are rates of molecular and PD-L1 biomarker testing in patients with advanced NSCLC in community practices, and do rates vary by sociodemographic factors? What is the prevalence of molecular biomarker mutations and PD-L1 expression levels?

Study Design And Methods: From 389 stage IV NSCLC pathology reports obtained through the University of North Carolina Lineberger Comprehensive Cancer Center's Rapid Case Ascertainment Program from 38 community hospitals across North Carolina, we abstracted demographics, histology, molecular biomarker testing and results, and PD-L1 testing and expression. We geocoded patient and hospital addresses to determine travel time, distance to care, and census block level contextual variables.

Lung Cancer Screening With Low Dose Computed Tomography in Patients With and Without Prior History of Cancer in the National Lung Screening Trial.

Introduction: Patients with a prior history of cancer (PHC) are at increased risk of second primary malignancy, of which lung cancer is the most common. We compared the performance metrics of positive screening rates and cancer detection rates (CDRs) among those with versus without PHC.

Methods: We conducted a secondary analysis of 26,366 National Lung Screening Trial participants screened with low dose computed tomography between August 2002 and September 2007.

Cancer pain management in the emergency department: a multicenter prospective observational trial of the Comprehensive Oncologic Emergencies Research Network (CONCERN).

Purpose: Many patients with cancer seek care for pain in the emergency department (ED). Prospective research on cancer pain in this setting has historically been insufficient. We conducted this study to describe the reported pain among cancer patients presenting to the ED, how pain is managed, and how pain may be associated with clinical outcomes.

Age at initiation of screening mammography by family history of breast cancer in the breast cancer surveillance consortium.

Purpose: Women with a first-degree family history of breast cancer (FHBC) are sometimes advised to initiate screening mammography when they are 10 years younger than the age at which their youngest relative was diagnosed, despite a lack of unambiguous evidence that this is an effective strategy. It is unknown how often this results in women initiating screening earlier (< 40 years) than screening guidelines recommend for average-risk women.

Methods: We examined screening initiation age by FHBC and age at diagnosis of the youngest relative using data collected by the Breast Cancer Surveillance Consortium on 74,838 first screening mammograms performed between 1996 and 2016.

Validation of the Emergency Severity Index (Version 4) for the Triage of Adult Emergency Department Patients With Active Cancer.

Background: Patients with active cancer account for a growing percentage of all emergency department (ED) visits and have a unique set of risks related to their disease and its treatments. Effective triage for this population is fundamental to facilitating their emergency care.

Objectives: We evaluated the validity of the Emergency Severity Index (ESI; version 4) triage tool to predict ED-relevant outcomes among adult patients with active cancer.

Analysis of Diagnoses, Symptoms, Medications, and Admissions Among Patients With Cancer Presenting to Emergency Departments.

Importance: Better understanding of the emergency care needs of patients with cancer will inform outpatient and emergency department (ED) management.

Objective: To provide a benchmark description of patients who present to the ED with active cancer.

Design, Setting, And Participants: This multicenter prospective cohort study included 18 EDs affiliated with the Comprehensive Oncologic Emergencies Research Network (CONCERN).

Insurance-Based Differences in Time to Diagnostic Follow-up after Positive Screening Mammography.

Background: Insurance may lengthen or inhibit time to follow-up after positive screening mammography. We assessed the association between insurance status and time to initial diagnostic follow-up after a positive screening mammogram.

Methods: Using 1995-2010 data from a North Carolina population-based registry of breast imaging and cancer outcomes, we identified women with a positive screening mammogram.