An expert on the panel discussion of lung cancer screening from the Quantitative Imaging Workshop XIX, Joelle Fathi, DNP, RN, ARNP, CTTS, FAAN, Chief Healthcare Delivery Officer for the GO2 Foundation for Lung Cancer, called the lung cancer screening study a powerful reminder of the reality on the front lines of primary care. According to Dr. Fathi, a review of the literature reinforced the important role comorbidities may play in influencing primary care providers to offer lung cancer screening or have a shared decision-making conversation with patients.
“Based on my experience as a primary care provider, however, we’re not paying enough attention to health-care delivery and how to effectively utilize cancer screening in that setting,” she added. Dr. Fathi also noted a large database study from Morehouse School of Medicine of electronic health records. It demonstrated a 45% lung cancer screening rate among eligible patients, much higher than the national screening uptake rate of 2% to 5%.1
Joelle Fathi, DNP, RN, ARNP, CTTS, FAAN
“Lung cancer screening [at Morehouse] is so much higher than the rest of the country because their health system has a real emphasis on educating their providers about lung cancer screening with dedicated time and resources to lung cancer screening,” said Dr. Fathi. “Unfortunately, many of our health-care delivery systems are not positioning primary care providers with the resources necessary to do this important work.”
A Duty to Educate Patients
As Dr. Fathi explained, health-care providers have a duty to educate patients about the potential harms and benefits of all screening and therapeutic management options, regardless of the cancer or condition being treated. Singling out lung cancer screening as a unique burden on the health system has confused providers and possibly hindered care.
“We have done ourselves a disservice by calling out shared decision-
making in the lung cancer screening process, when it is really no different from what we do—and what we should be doing—in other cancers, such as colorectal, prostate, or breast,” said Dr. Fathi. “We have so much work to do, and I worry that we are making this issue more complex than it needs to be."
DISCLOSURE: Dr. Fathi reported no conflicts of interest.
1. Shah M, et al: Assessment and efficacy of low-dose CT screening and primary care providers perspective on lung cancer screening. Cureus 13(3):e13778, 2021.
Despite the benefits of lung cancer screening, including the high cure rate when found by screening compared to being discovered based on symptoms, the uptake of this technique among those who are eligible and where the screening is fully covered by insurance remains dismally low, on the order of...