Early Detection of Lung Cancer in WomEN (EDEN) Study
Source: American College of Radiology Harvey L. Neiman Health Policy Institute
Role: Principal Investigator
Period: 01/01/2017 – 12/31/2018
Total Costs: $25,000
The Early Detection of Lung Cancer in WomEN (EDEN) Study aims to determine the feasibility of recruiting women for low-dose CT screening for lung cancer in the mammography setting.
Despite coverage and the rapid proliferation of lung cancer screening programs, uptake of LDCT services has grown very slowly and sub-optimally due to a host of factors. First, many primary care providers remain unaware of recent data and policy changes regarding implementation of lung cancer screening. This is exacerbated by almost zero awareness of the option to pursue lung cancer screening among the general public and the target population of individuals who might benefit. Second, even among clinicians and the population of individuals at risk who are aware of lung cancer screening, provider and patient preferences remain inconsistent with screening participation and are likely influenced by misinformation, biases associated with current and previous tobacco use, stigma associated with lung cancer, and fatalistic or at best pessimistic beliefs about lung cancer treatment options. Third, while health care systems have begun to adopt and implement lung cancer screening programs, these programs are just beginning the process of developing the necessary operational systems to support high quality screening and need to develop referral patterns and care pathways that can translate into optimal screening processes and outcomes that reduce mortality. The slow uptake of lung cancer screening can be understood from the traditional challenges of diffusing health innovations; however, the substantial potential benefit of this life-saving intervention warrants early efforts to facilitate implementation and innovative approaches to reach this underserved and commonly difficult to engage population of individuals at high risk for lung cancer.
One approach to reach women at risk for lung cancer involves creating a teachable moment by leveraging women’s engagement with mammography, the most widely adopted cancer screening modality among women over 50. The mammography setting provides a unique opportunity to raise awareness and expand opportunities for lung cancer screening uptake. By identifying women who meet basic lung cancer screening eligibility criteria, it would be possible to implement an awareness campaign or referral pathways to facilitate informed choices about lung cancer screening. While using the teachable moment framework is not novel within cancer screening, it has yet to be considered in the context of lung cancer screening. While there is a rational appeal to this approach, feasibility must be an initial consideration, and this study will utilize the resources of the Harvey L. Neiman Health Policy Institute and the American College of Radiology to explore program-level perspectives on receptivity among mammography programs to integrate consideration of lung cancer screening into clinical practice routines.