Instructor, Division of Oncologic Sciences, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon.
Director, Patient Advocacy, Kinnate Biopharma Inc., San Francisco, California.
J Am Coll Radiol. 2022 Jun;19(6):757-768. doi: 10.1016/j.jacr.2022.02.041. Epub 2022 Apr 25.
The authors describe a rural community hospital's approach to lung cancer screening using low-dose CT (LDCT) to address the high incidence of lung cancer mortality.
An implementation project was conducted, documenting planning, education, and restructuring processes to implement a lung cancer screening program using LDCT in a rural community hospital (population 64,917, Rural-Urban Continuum Code 5) located in a region with the highest lung cancer mortality in Oregon. The hospital and community partners organized the implementation project around five recommendations for an efficient and effective lung cancer screening program that accurately identifies high-risk patients, facilitates timely access to screening, provides appropriate follow-up care, and offers smoking cessation support.
Over a 3-year period (2018-2020), 567 LDCT scans were performed among a high-risk population. The result was a 4.8-fold increase in the number of LDCT scans from 2018 to 2019 and 54% growth from 2019 to 2020. The annual adherence rate increased from 51% in 2019 to 59.6% in 2020. Cancer was detected in 2.11% of persons scanned. Among the patients in whom lung cancer was detected, the majority of cancers (66.6%) were categorized as stage I or II.
This rural community hospital's approach involved uniting primary care, specialty care, and community stakeholders around a single goal of improving lung cancer outcomes through early detection. The implementation strategy was intentionally organized around five recommendations for an effective and efficient lung cancer screening program and involved planning, education, and restructuring processes. Significant stakeholder involvement on three separate committees ensured that the program's design was relevant to local community contexts and patient centered. As a result, the screening program's reach and adherence increased each year of the 3-year pilot program.
作者描述了一家农村社区医院通过使用低剂量 CT（LDCT）进行肺癌筛查的方法，以解决肺癌死亡率高的问题。
开展了一项实施项目，记录了在俄勒冈州肺癌死亡率最高的地区，为一家农村社区医院（人口 64917 人，城乡连续体代码 5）实施 LDCT 肺癌筛查项目的规划、教育和结构调整过程。医院和社区合作伙伴围绕五项建议组织实施项目，以实现高效、有效的肺癌筛查计划，准确识别高危患者，方便及时进行筛查，提供适当的随访护理，并提供戒烟支持。
在 3 年期间（2018-2020 年），对高危人群进行了 567 次 LDCT 扫描。结果显示，2018 年至 2019 年 LDCT 扫描数量增加了 4.8 倍，2019 年至 2020 年增长了 54%。2019 年的年度依从率从 51%增加到 2020 年的 59.6%。扫描人群中发现癌症的比例为 2.11%。在发现肺癌的患者中，大多数癌症（66.6%）为 I 期或 II 期。
这家农村社区医院的方法是将初级保健、专科保健和社区利益相关者团结在一个目标周围，通过早期发现来改善肺癌的结果。实施策略是围绕五项有效和高效的肺癌筛查计划建议进行组织的，包括规划、教育和结构调整过程。三个不同委员会的大量利益相关者参与确保了该计划的设计与当地社区背景和以患者为中心相关。因此，在为期 3 年的试点项目的每一年，筛查计划的覆盖范围和参与度都有所增加。
