Taking Lung Cancer Screening on the Road

Carolinas HealthCare System, Levine Cancer Institute will be honored with a 2017 Innovator Award at the ACCC 34^th National Oncology Conference in Nashville, in October, for their development of the first mobile CT unit for lung cancer screening in the U.S., bringing state-of-the-art technology to rural communities.

As the oncology community is well aware, despite improvements to the early diagnosis, systemic immunotherapies, and gene-directed treatments of lung cancer, mortality rates remain high for this disease. A number of factors underlie this high death rate: the nature and natural history of the disease itself, poor access to care among continuing and recent smokers, lack of health education, fiscal and cultural issues, social stigma, and geographical isolation, among others. When patients present with Stage 1 (localized) lung cancer, surgical cure is possible in more than 50% of cases; when patients present with metastatic disease, for practical purposes, cure is highly unlikely.

Given that geographical isolation and barriers to care access are such important determinants of outcome, the Levine Cancer Institute sought to develop a program that would help to identify and eliminate barriers in high-risk and underserved communities.

Supported by a grant from the Bristol-Myers Squibb Foundation and in collaboration with Samsung and Frazerbilt, Levine Cancer Institute has developed the first mobile CT lung cancer screening unit in the United States.

Our mobile screening vehicle consists of a conventional low-dose Samsung CT unit mounted onto a robust, well-sprung truck body, with a built-in clinical space. Initial testing has demonstrated the fidelity of the unit, as well as the lack of impact of on- and off-road transportation on the functionality and image quality of the scanner.

We have also created a mechanism for electronic image transfer for reporting at a central location by the staff of partner radiology groups like Charlotte Radiology, Stanly Imaging, and Shelby Radiological Associates. Watch our video and learn more.

The entire program, one of several lung cancer projects of different types supported by the Bristol-Myers Squibb Foundation, is directed toward underserved and under-privileged populations. Our program includes several social components, including outreach and education on lung cancer screening for local physicians, nurse navigation and education, patient outreach with smoking cessation programs, and meticulous follow-up to avoid the loss of patients with identified lesions. Carolinas HealthCare System, the largest safety-net health organization in the Carolinas, has committed to providing optimal care to any patients shown to have lesions requiring further investigation, irrespective of their ability to pay; this care includes follow-up and repeat scanning; biopsy; and surgical, radiation, or systemic treatment.

We have already identified cases of early stage disease that have been directed towards definitive and hopefully curative treatment. In addition to the potential to improve patient outcomes, surgical treatment of early stage lung cancer is far less costly to the community than palliating the disease via systemic therapy. Through our program, we anticipate much improved outcomes for lung cancer treatment at a substantially reduced cost in the community.

Mellisa Wheeler, BSW, MHA, is Disparities & Outreach Manager, Levine Cancer Institute, and Derek Raghavan, MD, PhD, FACP, FRACP, is President, Levine Cancer Institute, Carolinas HealthCare System.

Hear details on the Levine Cancer Institute lung screening program and see their mobile CT unit at the ACCC 34^th National Oncology Conference in Nashville, Oct. 18-20.