Pilot intervention to increase uptake of lung cancer screening through the emergency department

• Published in: The American journal of emergency medicine 2024-05, Vol.79, p.157-160
• Main Authors: Pettit, Nicholas R., Horner, Diane, Freeman, Sara, Rieger, Karen
• Format: Article
• Language: English
• Subjects: Cancer; Cancer screening; Cardiovascular disease; Chronic obstructive pulmonary disease; Computed tomography; Coronary artery disease; COVID-19; Demographics; Early Detection of Cancer - methods; Electronic health records; Emergency department; Emergency medical care; Emphysema; Feasibility; Feasibility studies; Health care access; Heart diseases; Hospitals; Humans; Lung cancer; Lung Neoplasms - diagnostic imaging; Lung nodules; Mass Screening - methods; Medical imaging; Medical screening; Patients; Pilot Projects; Preventive health; Preventive medicine; Primary care; Referral and Consultation; Smoking; Success; Tobacco; Tomography, X-Ray Computed - methods
• ISSN: 0735-6757; 1532-8171; 1532-8171
• DOI: 10.1016/j.ajem.2024.02.019

The goal of this study is to demonstrate the feasibility of referring patients for lung cancer screening (LCS) from the emergency department (ED) as a method to increase the uptake of LCS. This is a single-arm pilot study at a large safety-net ED. ED LCS-eligible patients were offered a referral to our LCS clinic upon ED discharge. The primary outcome was the frequency at which patients connected with the LCS clinic. During the study period, 105 patients were approached; 26 (24.8%) participated. Reasons for non-enrollment include 29 (27.6%) who were not interested in research, 10 (9.5%) who did not speak English, and 40 (38.1%) who did not meet the pack-years criteria. Seventeen patients (65.4%, 17/26) connected with the LCS clinic, with 10 (38.5%) having been seen in the clinic and received a low dose computed tomography (LDCT) scan. Of the 17 that were connected with the clinic, 7 (26.9%) had a non-LDCT chest CT scan in the past year. Of those that were not seen in the clinic (n = 9), 4 (44.4%) were unreachable via 3 phone calls and a post-marked letter, and 3 (33.3%) did not attend the scheduled appointment, and 2 (22.2%) were delayed due to COVID-19. Of those that had CT scans over the study period (n = 17), 0 scans were normal, one patient (5.9%) had asymptomatic lung cancer, 7 (41.2%) had pulmonary nodules, 11 (64.7%) had emphysema, and 9 (52.9%) had coronary artery disease. This pilot study suggests the feasibility and suggests initial indications of the efficacy of referring ED patients for LCS.