Patient navigation for lung cancer screening among current smokers in community health centers a randomized controlled trial
Abstract Annual chest computed tomography (CT) can decrease lung cancer mortality in high‐risk individuals. Patient navigation improves cancer screening rates in underserved populations. Randomized controlled trial was conducted from February 2016 to January 2017 to evaluate the impact of a patient...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2018-03-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.1297 |
| _version_ | 1797390112760266752 |
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| author | Sanja Percac‐Lima Jeffrey M. Ashburner Nancy A. Rigotti Elyse R. Park Yuchiao Chang Salome Kuchukhidze Steven J. Atlas |
| author_facet | Sanja Percac‐Lima Jeffrey M. Ashburner Nancy A. Rigotti Elyse R. Park Yuchiao Chang Salome Kuchukhidze Steven J. Atlas |
| author_sort | Sanja Percac‐Lima |
| collection | DOAJ |
| description | Abstract Annual chest computed tomography (CT) can decrease lung cancer mortality in high‐risk individuals. Patient navigation improves cancer screening rates in underserved populations. Randomized controlled trial was conducted from February 2016 to January 2017 to evaluate the impact of a patient navigation program on lung cancer screening (LCS) among current smokers in five community health centers (CHCs) affiliated with an academic primary care network. We randomized 1200 smokers aged 55–77 years to intervention (n = 400) or usual care (n = 800). Navigators contacted patients to determine LCS eligibility, introduce shared decision making about screening, schedule appointments with primary care physicians (PCPs), and help overcome barriers to obtaining screening and follow‐up. Control patients received usual care. The main outcome was the proportion of patients who had any chest CT. Secondary outcomes were the proportion of patients contacted, proportion receiving LCS CTs, screening results and number of lung cancers diagnosed. Of the 400 intervention patients, 335 were contacted and 76 refused participation. Of the 259 participants, 124 (48%) were ineligible for screening; 119 had smoked <30 pack‐years, and five had competing comorbidities. Among the 135 eligible participants in the intervention group, 124 (92%) had any chest CT performed. In intention‐to‐treat analyses, 124 intervention patients (31%) had any chest CT versus 138 control patients (17.3%, P < 0.001). LCS CTs were performed in 94 intervention patients (23.5%) versus 69 controls (8.6%, P < 0.001). A total of 20% of screened patients required follow‐up. Lung cancer was diagnosed in eight intervention (2%) and four control (0.5%) patients. A patient navigation program implemented in CHCs significantly increased LCS among high‐risk current smokers. |
| first_indexed | 2024-03-08T23:06:56Z |
| format | Article |
| id | doaj.art-e74ead5f05d341bd81056eb2a8e0f8bc |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-03-08T23:06:56Z |
| publishDate | 2018-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-e74ead5f05d341bd81056eb2a8e0f8bc2023-12-15T12:32:12ZengWileyCancer Medicine2045-76342018-03-017389490210.1002/cam4.1297Patient navigation for lung cancer screening among current smokers in community health centers a randomized controlled trialSanja Percac‐Lima0Jeffrey M. Ashburner1Nancy A. Rigotti2Elyse R. Park3Yuchiao Chang4Salome Kuchukhidze5Steven J. Atlas6Division of General Internal Medicine Massachusetts General Hospital Boston MassachusettsDivision of General Internal Medicine Massachusetts General Hospital Boston MassachusettsDivision of General Internal Medicine Massachusetts General Hospital Boston MassachusettsMongan Institute for Health Policy Massachusetts General Hospital Boston MassachusettsDivision of General Internal Medicine Massachusetts General Hospital Boston MassachusettsMassachusetts General Hospital Cancer Center Boston MassachusettsDivision of General Internal Medicine Massachusetts General Hospital Boston MassachusettsAbstract Annual chest computed tomography (CT) can decrease lung cancer mortality in high‐risk individuals. Patient navigation improves cancer screening rates in underserved populations. Randomized controlled trial was conducted from February 2016 to January 2017 to evaluate the impact of a patient navigation program on lung cancer screening (LCS) among current smokers in five community health centers (CHCs) affiliated with an academic primary care network. We randomized 1200 smokers aged 55–77 years to intervention (n = 400) or usual care (n = 800). Navigators contacted patients to determine LCS eligibility, introduce shared decision making about screening, schedule appointments with primary care physicians (PCPs), and help overcome barriers to obtaining screening and follow‐up. Control patients received usual care. The main outcome was the proportion of patients who had any chest CT. Secondary outcomes were the proportion of patients contacted, proportion receiving LCS CTs, screening results and number of lung cancers diagnosed. Of the 400 intervention patients, 335 were contacted and 76 refused participation. Of the 259 participants, 124 (48%) were ineligible for screening; 119 had smoked <30 pack‐years, and five had competing comorbidities. Among the 135 eligible participants in the intervention group, 124 (92%) had any chest CT performed. In intention‐to‐treat analyses, 124 intervention patients (31%) had any chest CT versus 138 control patients (17.3%, P < 0.001). LCS CTs were performed in 94 intervention patients (23.5%) versus 69 controls (8.6%, P < 0.001). A total of 20% of screened patients required follow‐up. Lung cancer was diagnosed in eight intervention (2%) and four control (0.5%) patients. A patient navigation program implemented in CHCs significantly increased LCS among high‐risk current smokers.https://doi.org/10.1002/cam4.1297Cancer screeninghealth centerlung cancerpatient navigationsmokers |
| spellingShingle | Sanja Percac‐Lima Jeffrey M. Ashburner Nancy A. Rigotti Elyse R. Park Yuchiao Chang Salome Kuchukhidze Steven J. Atlas Patient navigation for lung cancer screening among current smokers in community health centers a randomized controlled trial Cancer Medicine Cancer screening health center lung cancer patient navigation smokers |
| title | Patient navigation for lung cancer screening among current smokers in community health centers a randomized controlled trial |
| title_full | Patient navigation for lung cancer screening among current smokers in community health centers a randomized controlled trial |
| title_fullStr | Patient navigation for lung cancer screening among current smokers in community health centers a randomized controlled trial |
| title_full_unstemmed | Patient navigation for lung cancer screening among current smokers in community health centers a randomized controlled trial |
| title_short | Patient navigation for lung cancer screening among current smokers in community health centers a randomized controlled trial |
| title_sort | patient navigation for lung cancer screening among current smokers in community health centers a randomized controlled trial |
| topic | Cancer screening health center lung cancer patient navigation smokers |
| url | https://doi.org/10.1002/cam4.1297 |
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