Catalysts for Care: How Visionary Doctors are Driving Lung Cancer Screening Success

November 15, 2024

Each year lung cancer claims more lives than breast, cervical, and colon cancers combined. As the leading cause of cancer deaths worldwide, lung cancer is an incredibly daunting disease. But there is growing excitement in lung cancer screening, which means there is also reason for hope.

A new generation of forward-thinking doctors and researchers is revolutionizing how we detect and treat lung cancer. Through innovative approaches to screening and program implementation, pioneering physicians are making remarkable progress in finding lung cancer early, when it is most treatable.

A Screening Gap Costing Lives

Despite remarkable medical advances, lung cancer screening in the United States is significantly low: less than 6% of those who are eligible get screened. That’s especially alarming when you consider that screening rates for other cancers like colorectal are around 70%. Even among those who undergo lung cancer screening, the frequency with which people come back for annual screening is about half, far lower than rates of annual screening for other cancers.

The consequences of this screening gap are devastating. When lung cancer is detected early, at Stage 1, the 5-year survival rate skyrockets, and survivors – like Terri Ann DeJulio – can live well. But, because of the lack of screening, most lung cancers are found at the late stages, and consequently, the 5-year survival plummets to less than 8%.

What’s Holding Us Back?

There are several reasons why lung cancer screening rates lag so far behind other cancers:

• Screening Guidelines: Compared to other cancers, eligibility for lung cancer screening requires a history of smoking, whereas screening for breast, cervical, and colon cancer is only contingent upon age.

• Lack of Awareness: Many high-risk patients simply don’t know about screening guidelines and available tests, and they often find the opportunity to discuss eligibility with their provider hampered by rushed appointments and lack of communication.

• Stigma: Lung cancer’s strong link to tobacco use history has led to a pervasive stigma that deters people from getting screened. Decades of shame-based campaigns have caused many individuals who smoke to omit their smoking status to providers.

• Practical Barriers: Frequently, access to facilities that provide low-dose CT screening prevents patients from getting the necessary care. From scheduling difficulties to transportation challenges, and from out-of-pocket costs to radiation concerns – many eligible patients who have referrals do not follow through on their screening.

Empowering Doctors, Engaging Communities

To overcome the screening gaps, new thinking and tools are dedicated to improving screening, reducing barriers to low-dose CT scans, and drastically improving outcomes.

One such pioneer is Dr. Ali H. Zaidi. As an expert in lung and esophageal cancers, Dr. Ali Zaidi of Allegheny Health Network is leading the charge to transform lung cancer detection. By taking a comprehensive, patient-focused approach and leveraging the latest innovations, he and his colleagues at the AHN Cancer, Medicine and Primary Care Institutes are making remarkable strides. Their goal is nothing short of a paradigm shift.

In the next 10 years, Dr. Zaidi hopes to see lung cancer screening rates reach 60-70%, on par with other major cancers. “Screening,” he emphasizes, “is such an easy way to improve outcomes. And small investments have a big impact.”

It’s an ambitious but vital vision – one that Dr. Zaidi confidently believes is possible.

How will he and his colleagues help reach their goal? Zaidi explains that it’s a two-fold process: implementing a solution to close the gap; and promoting change at the programmatic level, including advocating for broadening screening eligibility criteria.

Screening Solutions

Key to the process is the development of cost-effective, convenient, highly accurate, and accessible solutions. Dr. Zaidi explains that while technological advances have made new screenings possible, adoption costs are often prohibitive.

“You can’t just deploy something and think it will make clinical sense. Disruptive technologies can overwhelm already burdened healthcare providers, sometimes making them hesitant to implement new methods.”

Many promising technologies fail because they need to establish a clear path to reimbursement or show economic viability. The goal of resolving the screening gap is not to replace low-dose CT scans but to better direct high-risk patients toward appropriate, convenient screenings. For example, a blood test like FirstLook Lung, conveniently and effectively identifies individuals at a higher risk of lung cancer, allowing for more efficient triaging of patients needing CT scans — and potentially doubling lung cancer detection rates from the same number of screenings.

Broadening Screening Eligibility

According to Dr. Zaidi, lung cancer screening lacks the accessibility and convenience of other cancer detection methods. Low-dose CT screenings are not point-of-care tests, complicating access for patients facing scheduling challenges, transportation, and taking time off work. The FirstLook Lung test provides reliable, quick results that aid in moving more patients onto the next phase of shared decision-making and low-dose CT, which can provide early disease identification.     

With a philosophy that tests like FirstLook Lung will encourage updates to screening guidelines and simplify eligibility criteria, Zaidi hopes programs will move away from reliance on stringently documented smoking history and instead focus on age-dependent measures, which have proven effective in other programs. “Broadening guidelines on eligibility should move the needle on lung cancer screening. Doing so will improve health rather than just providing health care.”

A Hopeful Future

Ultimately, Dr. Zaidi envisions an ideal workflow where patients are prioritized for FirstLook Lung; those with elevated results would receive a CT scan, while those with not-elevated results would be encouraged to return for screening annually. Primary care providers must also lead the charge in increasing public health awareness and in shifting the perceived stigma surrounding lung cancer – Zaidi reminds us that providers are pivotal in shared decision-making and in educating their patients about resources that increase access to screening opportunities.

Dr. Zaidi and his colleagues are reshaping the lung cancer screening landscape, and in doing so, they are optimistic that healthcare providers will turn breakthroughs into tangible improvements for their patients’ health.