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In an effort to encourage prevention, screening, research, and advocacy, the Forum of International Respiratory Societies created World Lung Cancer Day, observed on August 1 each year, and many ACCC member organizations actively contribute to that work.
In the last 30 years, there has been a steady decline in lung cancer cases and deaths in the United States, a testament to the success of screening and prevention programs. However, that progress has not dethroned lung cancer from the top of the list of deadliest cancers. It is currently the third most common new cancer diagnosis and accounts for more than twice as many deaths as any other cancer type.
In an effort to encourage prevention, screening, research, and advocacy, the Forum of International Respiratory Societies created World Lung Cancer Day, observed on August 1 each year, and many ACCC member organizations actively contribute to that work. Each year, the ACCC Innovator Awards spotlight cancer programs tackling the biggest hurdles in cancer care, including 3 recent projects focused on lung cancer detection and treatment.
Incidental findings are a normal part of radiology. An x-ray of a broken rib or a CT scan of the heart might unintentionally reveal an abnormal feature on the lungs. Only about 16% of eligible Americans receive dedicated screenings for lung cancer, so these incidental findings play an important role in detection and diagnosis.
The University of Colorado Cancer Center and UCHealth noticed that many patients with incidental lung findings weren’t receiving appropriate follow-ups. “A few patients diagnosed with late-stage lung cancer were found to have had overlooked incidental lung nodules on a past imaging scan—a devastating missed opportunity for early detection and diagnosis,” providers shared in their recent article in Oncology Issues.
Their solution was an AI program that identifies incidental lung nodules from scans, triages patients based on findings and other information in their radiology report, and integrates with existing electronic health record (EHR) systems to communicate with patients about necessary follow-up care. The program went live in September 2022 and immediately began making a positive impact. In just the first few months, incidental lung nodules were detected in 6500 patients and led to the diagnosis of 274 new cases of lung cancer. Importantly, 40% of these new cases were stage 1, the most treatable stage, compared to a national average of 20% of cases diagnosed that early.
This initiative, led by a multidisciplinary team of providers and researchers, earned the University of Colorado Cancer Center and UCHealth a 2024 ACCC Innovator Award. Since then, they have begun expanding this technology across UCHealth locations and to other disease states with plans to build a tracking module for patient surveillance after successful treatment of lung cancer.
Biomarkers are genes, proteins, and other molecules found in the body that can help identify characteristics of a disease and which treatments will be most effective. When biomarker testing first became available for non-small cell lung cancer (NSCLC), there were only 3 known markers to test for. Today, there are over a dozen and that number continues to grow.
More biomarkers mean more opportunities to tailor NSCLC treatment to each individual patient. However, patients only benefit if they receive all available tests. A study published in 2021 by the US Oncology Network found that 90% of people with lung cancer received some biomarker testing from 2018-2020, but less than half of these individuals received comprehensive testing. This means that known biomarkers were left unchecked which could have impacted their treatment decisions.
Oncology Hematology Care (OHC) was awarded a grant by Pfizer to create a program that increased comprehensive biomarker testing for patients with NSCLC. Their team developed educational videos for providers, a template in their EHR that included relevant National Comprehensive Cancer Network (NCCN) guidelines for testing, a new standard testing order that included the full range of relevant biomarker tests, and a data reporting system that provided weekly scorecards on how well the center’s testing was improving.
Prior to this initiative, 68% of OHC patients with NSCLC received comprehensive biomarker testing. After 1 year, that number jumped to 92.7% and won OHC a 2023 ACCC Innovator Award.
In a 2024 Oncology Issues article, providers from OHC offered their best tips to implement a similar quality improvement initiative at other cancer centers. They recommended starting small with simple educational opportunities and incorporating standardization whenever possible to streamline workflows.
In recognition of the crucial role early detection through screening plays in improving patient outcomes and reducing the burden of cancer, St. Elizabeth Healthcare, a community-based health care system with locations across Northern Kentucky and Southern Indiana, set out to increase its rate of lung cancer screenings. Beginning in 2018, their team started implementing social workers into their outreach strategies, then a medical assistant, then a virtual nurse triage team. Each of these programs were effective at increasing patient participation in screening, but were short-lived. The staff assigned to this role had other responsibilities and were often redirected to other tasks as part of workload changes.
Providers recognized that if they wanted to see lasting improvements in screening rates, they needed a dedicated outreach team. St. Elizabeth Healthcare created a Population Health Support Services team made up of 12 RNs trained in patient outreach and cancer screening education for lung cancer as well as breast and colorectal cancers. This program grew their lung cancer screening rates for eligible patients from 29.3% in 2020 to 44.1% in 2022, earning them a 2023 ACCC Innovator Award.
The increase in screenings is already leading to noticeable improvements in lung cancer care at St. Elizabeth Healthcare. The proportion of late-stage lung cancer diagnoses, which includes stages 3 and 4, dropped 23.1% from 2015 to 2022. This means more patients are starting care while their disease is still in its more treatable form.
The positive interactions between patients and providers are one of the keys to this program’s success. “Members of Population Health Support Services continuously stay true to the phrase ‘Smile and Dial,’” providers wrote in Oncology Issues. “We make every outreach attempt count by educating about the importance of preventive cancer screening and ways that it can save lives.”
The ACCC Innovator Awards are an annual opportunity to recognize and elevate member programs whose work moves the needle in delivering equitable, high-quality cancer care. Beyond congratulating these winners, ACCC is committed to showcasing their groundbreaking work in oncology so that other member programs can learn about innovative solutions they can take back and implement in their own institutions. The 42nd National Oncology Conference (NOC) is a chance for members to network, learn, and be inspired by their peers as they continue to shape the next frontier of oncology. Register now to join us on October 15-17 in Denver, Colorado and hear from the six 2025 ACCC Innovator Award winners.