Lung cancer (both small cell and non-small cell) is the second most common cancer in both men and women (excluding skin cancer). Non-small cell lung cancer accounts for about 84 percent of lung cancers; small cell lung cancer accounts for about 13 percent. In 2020, the American Cancer Society estimates that the U.S. will see about 228,820 new cases of lung cancer (116,300 in men and 112,520 in women), and about 135,720 deaths from the disease (75,500 in men and 63,220 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.
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 guided the selection of six cancer programs to serve as process improvement sites. Facilitated by ACCC, these six cancer programs are developing and conducting 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.
The Association of Community Cancer Centers (ACCC) has developed a model (or framework) that cancer programs and practices can employ for quality improvement initiatives aimed at improving care coordination for patients with lung cancer, with particular focus on improving care for those covered by Medicaid. Through a collaborative approach, informed by a comprehensive cross section of stakeholders, including community organizations, patients, and primary and specialty providers, ACCC developed and tested a framework for optimal care coordination for lung cancer patients. Using a beta version of the model, seven ACCC Cancer Program members completed quality improvement projects. The work is supported by a three-year grant from the Bristol Myers Squibb Foundation.
Identification of actionable biomarkers continues to drive application of precision medicine in oncology. For patients with lung cancer, molecularly targeted therapies based on expression of specific biomarkers may be potential treatment options. Only through biomarker testing can clinicians discover whether lung cancers have targetable biomarkers. The ACCC Eliminating Precision Medicine Disparities project will focus on understanding specific barriers and challenges to equal access to precision medicine among underserved patient communities.
Through this educational program, ACCC will identify and disseminate examples of effective practices and tools for developing, implementing, and assessing operational pathways for molecular testing for eligible patients with NSCLC.
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.