Enhancing adherence to lung cancer screening through a centralized program

SESSION TITLE: Lung Cancer Posters 2 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: Lung cancer is the leading cause of cancer death in men and women in the United States and world. Currently, smoking cessation and lung cancer screening are the only interventions that have demonstrated to decrease mortality from lung cancer. Lung cancer screening has been shown to reduce lung cancer mortality by 20-24% for high-risk patients (based on age and smoking status) in both the National Lung Screening Trial (NLST) and the Dutch-Belgian Randomized Lung Cancer Screening Trial (NELSON). Despite this evidence, we continue to face challenges with very low proportions of eligible patients having the opportunity to be screened. Several studies report non-adherence rates varying from 23 -45% across hospital systems. Our aim was to determine the effectiveness of a centralized program in improving patient adherence to lung cancer screening. METHODS: Henry Ford Health System in Metropolitan-Detroit launched a centralized LCS program through its Interventional Pulmonary team in 2018. We evaluated adherence, return within 12 to 18 months for the first and second annual scans, following a baseline screen between January 2015 and April 2021. Adherence was assessed following exams with a LungRADS score of 1 or 2. We accounted for patients who died within 18 months of exam date, did not have a full 18 months follow-up time in our dataset, or completed a computer tomography (CT) for another reason within 18 months. Adherence was assessed pre- and post-centralization of the LCS program. RESULTS: During the study period, 11,466 exams were considered eligible for annual screening of which 6,356 were considered baseline to first annual and 2,993 were first annual to second annual. Overall, the adherence rate for annual visits, ranging from one to seven, for patients with LungRADS 1 or 2 during the de-centralized period was 35%, with the rate increasing to 64% post-centralization of the LCS program. Adherence increased from pre- to post-centralization for both the first annual exam (pre=35%, post=56%) and second annual exam (pre=48%, post=70%). The overall adherence rate was higher for the second annual exam at 68% when compared to adherence for their first annual screening CT at 49%. The gap in adherence between Black and white patients decreased from 10% to 3% across centralization of the LCS program. CONCLUSIONS: In conclusion, centralization of the LCS program led to an improvement in adherence rates for annual visits among patients with LungRADS 1 or 2. These findings emphasize the positive impact of centralizing LCS programs on patient compliance and underscore the importance of continuous efforts to enhance program accessibility and patient engagement. CLINICAL IMPLICATIONS: Centralizing LCS programs can effectively improve adherence to annual screening visits for patients which may lead to more timely detection of lung cancer and better patient outcomes. These findings emphasize the need for healthcare systems to consider implementing centralized LCS programs to enhance patient compliance and streamline the screening process. Furthermore, they highlight the importance of continuous quality improvement initiatives, patient education, and targeted interventions to address potential barriers to adherence, ultimately leading to improved lung cancer detection, treatment, and survival rates. DISCLOSURES: No relevant relationships by Elizabeth Alleman No relevant relationships by Vritti Gupta No relevant relationships by Cindy Lambdin Grantee relationship with Genentech Please note: Jan 2021-Dec 2023 Added 03/31/2023 by Christine Neslund-Dudas, source=Web Response, value=Grant/Research Support Consultant relationship with CleanScreen Consulting L.L.C. Please note: 2021 by Lana Saugrich, value=Salary No relevant relationships by Michael Sheehan Scientific Medical Advisor relationship with Gongwin Biopharm Please note: $5001 - $20000 by Michael Simoff, value=Consulting fee Employee relationship with Intuitive Please note: Feb 2022 to current by Michael Simoff, value=Salary No relevant relationships by Katie Zarins