Community hospitals can quickly implement lung cancer screening programs

A low-dose CT lung screening program can be put into place pretty quickly in a community hospital setting, according to an article published online in the Journal of the American College of Radiology.

Physicians from Elkhart (Ind.) General Hospital, led by Samir Patel, reported in JACR that they were able to implement all the important components of a screening program--such as defining eligibility criteria, performing a low-dose CT protocol, using standardized structured reporting and developing a group of experts for consulting and management.

The incentive to implement a program at Elkhart was heightened due to a high smoking rate in Elkhart Country. According to the authors, the county's smoking rate of 23.4 percent is among the states highest and well above the average of 17 percent. In addition, about 50 percent of lung cancer cases diagnosed in the area over the last decade were stage IV cancers.

Individuals who were potential candidates for screening were asked to evaluate whether they were at high risk for developing lung cancer based on factors such as their smoking history, age, and current and former smoking status. If a CT request was made, patients were informed about costs and hospital staff worked to find the most effective price for patients whose screening exams weren't covered by insurance.

Patients were screened with a low-dose CT protocol, and were then contacted in order to discuss exam results and appropriate follow up, including smoking cessation counseling.

In the first 13 months of the program, 150 patients were screened, with 100 recommended to undergo 12-month follow-ups, 28 to undergo six-month follow-ups, 11 to undergo three-month follow-ups, and two to undergo biopsy.

The authors wrote that they hoped their experience could help other hospitals facilitate the development of low-dose CT lung screening programs.

The ability of community hospitals to implement CT lung screening programs has become more timely with the recent decision by the United States Preventive Services Task Force to give CT lung cancer screening a positive recommendation. Consequently, the Centers for Medicare & Medicaid Services on February 10 opened up a 30-day comment period regarding whether Medicare should cover CT lung screening.

To learn more:
- see the article in JACR

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