In 2013—the first year that St. Elizabeth Healthcare offered low-dose CT scans to Kentucky residents to detect possible signs of lung cancer—seven people were tested. In 2014, that number rose to 250 people, and in 2015, 700 people were scanned.
But the oncologists at St. Elizabeth—located in Edgewood, Kentucky—knew that that wasn’t enough. Michael Gieske, MD, the medical director of St. Elizabeth’s lung cancer screening program, calls Kentucky “ground zero” in the fight against lung cancer. Kentucky ranks worst in the country for lung cancer diagnosis and death rates, and it is consistently one of the top two states (with West Virginia) in smoking rates, according to 2018 CDC data.
“The national incidence rate for lung cancer is 17 percent nationwide,” says Dr. Gieske. “In Kentucky, it is 25 percent. There are also more deaths from lung cancer in Kentucky than the next five cancers combined.”
Adding to the crisis is the fact that patients in Kentucky are generally diagnosed at a later stage in the disease, when survival rates are significantly lower.
Motivated by these disturbing statistics, St. Elizabeth’s physicians went beyond their healthcare campus to educate primary care practices in the region and spread the word about St. Elizabeth’s low-dose CT lung cancer screening. “I launched an educational campaign, speaking to our leadership and management team and local primary care leadership, to get word out that this fast, low-dose scanning service is available and can make a tremendous difference in the lives of patients,” says Dr. Gieske.
“We reached out to our population through advertising; we posted a questionnaire on our website,” he says. “Whenever patients come into our offices for health maintenance, a prompt alerts providers that a patient may qualify for a screening test.”
The results have been nothing short of remarkable.
In October 2019, St. Elizabeth Healthcare performed its 10,000th lung screening, a significant and rare milestone achieved only by a handful of other health systems in the country. The system’s estimated rolling 12-month completion rate for patients eligible for the screening is approximately 36 percent, significantly exceeding the national average of less than 5 percent. “The state of Kentucky is now at number four in the country for lung cancer screening,” says Dr. Gieske. “And, with a series of state-based initiatives, we will definitely move up the list in the near future.”
St. Elizabeth is also detecting lung cancer earlier—which can be essential to survivorship. When lung cancer is diagnosed and treated early (at stage I), the five-year survival rate can exceed 90 percent. Dr. Gieske says that St. Elizabeth’s screening detects lung cancer in approximately 1 out of each 62 scans, which has totaled 175 confirmed cases since 2013. Of those cases, 67 percent have been at stage I or stage II.
“By finding these tumors at stage I or stage II, we are seeing a ‘stage migration’ shift,” says Dr. Gieske. “Pinpointing tumors at lower stages significantly increases chances of survival. Early detection offers more options, namely allowing St. Elizabeth surgeons and their teams to remove the tumors and often spare lung cancer patients the need for chemotherapy. Patients can be in and out of the hospital in three days. It’s so rewarding to see patients do so well with lung cancer. You usually don’t see that at later stages of cancer. The screenings are extending and saving lives.”
