Patient-clinician discussions on lung cancer screening in the United States before and after 2021 guidelines.

Background: Screening for lung cancer via low-dose computed tomography of the chest can promote early detection and reduce mortality. However, since the United States Preventive Service Task Force (USPSTF) issued lung cancer screening guidelines in 2013, uptake has been low. The USPSTF revised the guidelines in 2021 to expand eligibility.

Evaluating Pragmatism of Lung Cancer Screening Randomized Trials with the PRECIS-2 Tool.

Objective: Lung cancer screening (LCS) implementation has been challenging for community and rural primary care settings. One contributing factor may be that the randomized clinical trials (RCTs) that form the evidence base are guided by explanatory methods not reflective of primary care settings. This study applied the agmatic xplanatory ontinuum ndicator ummary (PRECIS - 2) tool to determine the pragmatism of LCS RCTs envisioned through a decentralized, primary care lens.

A study protocol for a mixed-method environmental scan of contextual factors that influence lung cancer screening adherence.

Background: The efficacy of lung cancer screening (LCS) to reduce lung cancer specific mortality is heavily dependent on adherence to recommended screening guidelines, with real-world adherence rates reported to be drastically lower than rates described in clinical trials. There is a dearth in the literature on reminder processes and clinical workflows used to address adherence and robust data is needed to fully understand which clinical set-ups, processes, and context enhance and increase continued LCS participation. This paper describes a protocol for an environmental scan of adherence and reminder processes that are currently used in LCS programs across the United States.

"They Need to Feel Non-Judgmental": Results of Participatory Photovoice Research to Inform Lung Cancer Screening Imagery.

Introduction: Effective communication and messaging strategies are crucial to raise awareness and support participants' efforts to adhere to lung cancer screening (LCS) guidelines. Health messages that incorporate images are processed more efficiently, and given the stigma surrounding lung cancer and cigarette smoking, emphasis must be placed on selecting imagery that is engaging to LCS-eligible individuals. This exploratory study aimed to identify person-centered themes surrounding LCS imagery.

Results of a pilot risk-based lung cancer screening study: outcomes and comparisons to a Medicare eligible cohort.

Purpose: Risk-based lung cancer screening holds potential to detect more cancers and avert more cancer deaths than screening based on age and smoking history alone, but has not been widely assessed or implemented in the United States. The purpose of this study was to prospectively identify patients for lung cancer screening based on lung cancer risk using the PLCO model and to compare characteristics, risk profiles, and screening outcomes to a traditionally eligible screening cohort.

Methods: Participants who had a 6 year lung cancer risk score ≥ 1.

Differences in VA and Non-VA Pulmonary Nodules: All Evaluations Are not Created Equal.

Background: Indeterminate pulmonary nodules present a common challenge for clinicians who must recommend surveillance or intervention based on an assessed risk of malignancy.

Patients And Methods: In this cohort study, patients presenting for indeterminate pulmonary nodule evaluation were enrolled at sites participating in the Colorado SPORE in Lung Cancer. They were followed prospectively and included for analysis if they had a definitive malignant diagnosis, benign diagnosis, or radiographic resolution or stability of their nodule for > 2 years.

Determinants Associated With Longitudinal Adherence to Annual Lung Cancer Screening: A Retrospective Analysis of Claims Data.

Objective: Lung cancer screening (LCS) efficacy is highly dependent on adherence to annual screening, but little is known about real-world adherence determinants. We used insurance claims data to examine associations between LCS annual adherence and demographic, comorbidity, health care usage, and geographic factors.

Materials And Methods: Insurance claims data for all individuals with an LCS low-dose CT scan were obtained from the Colorado All Payer Claims Dataset.

Impact of a Hybrid Lung Cancer Screening Model on Patient Outcomes and Provider Behavior.

Background: Lung cancer screening (LCS) implementation is complicated by the Centers for Medicare and Medicaid Services reimbursement requirements of shared decision-making and tobacco cessation counseling. LCS programs can utilize different structures to meet these requirements, but the impact of programmatic structure on provider behavior and screening outcomes is poorly described.

Patients And Methods: In a retrospective chart review of 624 patients in a hybrid structure, academic LCS program, we compared characteristics and outcomes of primary care provider (PCP)- and specialist-screened patients.