Lung cancer (both small cell and non-small cell) is the second most common cancer in both men and women (excluding skin cancer), accounting for about 14 percent of all new cancers. In 2018, the American Cancer Society estimates that the U.S. will see about 234,030 new cases of lung cancer (121,680 in men and 112,350 in women), and about 154,050 deaths from the disease (83,550 in men and 70,500 in women).
While the prognosis of lung cancer is serious, ongoing advances in lung cancer screening, diagnosis, along with new and evolving treatments modalities are bringing new options for patients with lung cancer
Source: American Cancer Society. Key Statistics for Lung Cancer.
In December 2013, the U.S. Preventive Services Task Force (USPSTF) grade "B" recommendation for CT screening for high-risk individuals was made final. The USPSTF defines as high-risk factors as:
On February 5, 2015, the Centers for Medicare & Medicaid Services (CMS) issued a final national coverage determination (NCD) that provides for Medicare coverage of screening lung cancer with low dose computed tomography (LDCT). The coverage was effective immediately.
Many ACCC member programs are interested in developing and/or enhancing their programs for lung cancer screening. ACCC is pleased to partner with the Lung Cancer Alliance (LCA) on a web section featuring resources on lung cancer screening programs.
Explore Lung Cancer Screening Resources
The Association of Community Cancer Centers (ACCC) is partnering with the American College of Chest Physicians (CHEST), the International Association for the Study of Lung Cancer (IASLC), and the LUNGevity Foundation on a national initiative to identify and provide guidance on key issues related to delivering optimal care for patients diagnosed with stages III or IV non-small cell lung cancer (NSCLC) across different practice settings.
As a first step in the Fostering Excellence in Care and Outcomes for Patients with Stage III and IV NSCLC initiative, ACCC conducted a survey to better understand the barriers and operational challenges in providing care for this patient population. Survey questions addressed diagnosis, treatment, care coordination, and communication within the interdisciplinary team caring for patients with locally advanced and late-stage NSCLC.
Informed by the survey results, the project’s Steering Committee will guide the selection of six cancer programs to serve as process improvement sites. Facilitated by ACCC, the six selected sites will create and execute process improvement models aimed at overcoming identified barriers to excellence in care for patients with these NSCLC stages. The models tested will be applicable across care settings. Results will be shared with the wider oncology community.
Advances in diagnostics and treatments for lung cancer have led to the development of targeted therapies for some lung cancer subtypes. Patients with ALK+ non-small cell lung cancer (NSCLC) may be appropriate candidates for such targeted therapy. Previously, this ACCC education project explored barriers and issues related to testing and treating patients with ALK+ NSCLC, a less common subtype of NSCLC. In this latest project report, read how five ACCC Cancer Program members are effectively diagnosing and managing patients with ALK+ NSCLC. Approaches include thoracic oncology teams working to optimize molecular testing, telemedicine, leveraging EHR technology, and more.
In 2016 the Association of Community Cancer Centers (ACCC) launched a three-year initiative to develop an optimal care coordination model to serve Medicaid patients with lung cancer. Through a collaborative approach, the project will focus on building effective partnerships among community organizations, patients, and primary and specialty providers with the goal of providing stakeholders a scalable plan for outreach and treatment that is replicable and sustainable across cancer programs. Seven ACCC Cancer Program members are currently conducting quality improvement projects to test a care coordination model developed through this project. The work is supported by a three-year grant from the Bristol-Myers Squibb Foundation (BMSF).
The evolution of biomarker-driven medicine to diagnose and treat lung cancer continues to play a central role in the delivery of precision medicine for patients. Bio-marker testing provides specific information about a patient’s tumor that can be used in diagnosis, development of a treatment plan, and in following the patient’s progress. ACCC process improvement resources focused on molecular testing in lung cancer include:
This white paper explores the unique challenges facing this growing patient population, including disparity and access issues, communication and cultural barriers, and issues related to lung cancer management and treatment. Plus, practical improvement strategies to help cancer programs meet these challenges and improve patient care.