Implementation of a standardized lung cancer screening protocol at a central Michigan internal medicine practice : a DNP project

Background: Lung cancer is the number one cause of cancer-related deaths in the United States, with more than 234,580 new cases anticipated to be diagnosed in 2024. Despite this, only an estimated five percent of eligible patients will be assessed. This underscores the importance of provider-led smoking cessation and early detection via low-dose CT scan to reduce mortality. Despite a larger, more diverse screening population specified in the 2014 USPSTF guidelines for lung cancer detection, utilization of standardized guidelines is inconsistent and varied amongst primary care providers, even within the same practice setting. This evidence-based project aimed to establish a lung cancer screening protocol with a central Michigan internal medicine practice using provider education, standardized patient screening tools, and shared decision-making. Research question: In adult patients aged 50-80 who are current or former smokers, what is the effect of implementing a lung cancer screening program at an outpatient internal medicine clinic on lung cancer screening rates, within twelve weeks? Methods: A standardized screening tool was created and distributed to providers and staff with an in-service program, and data was collected from the electronic health record over 12 weeks. Following the intervention period, patient data was reviewed to assess rates of scans ordered, completed, rejected, or otherwise deferred. Results: In the 12-week implementation phase, 37 patients were identified as current or former smokers. Of this group, 24 patients were determined to be eligible for ordering an LDCT. 16 scans were ordered and 16 patients (43.2%) completed LDCT scans for screening. Six (16.2%) declined to complete imaging, and two (5.4%) had already completed scans within the previous 12-month period. Interpretation: Establishment of a LDCT Lung Cancer Screening Protocol is associated with increased rates of lung cancer screenings being ordered and completed. However, limitations around EHR incorporation, provider and practice communication, reasons for patient participation decline, and rates of lung cancer detection warrant further research. Keywords: lung cancer screening; shared decision-making, low dose computed tomography, internal medicine practice, United States Preventative Task Force recommendations

Authors dc:creator

• Kasper, Megan
• Vanderslice, Avalon
• Vermeulen, Anne (Anne Carol)

Contributors dc:contributor

• Hinkle, Jeneen

• Lungs--Cancer--Diagnosis
• Cancer--Tomography
• Lungs--Tomography
• Cigarette smokers--Medical examinations

Statement dc:rights

• In Copyright

Language dc:language

English

Identifier

dnp:74
oclc:1569639871
local:R_6126AzPwQXZf8uR

OAI identifier oai:identifier

oai:d.lib.msu.edu:dnp_74