INPUT from a nurse navigator has led to the discovery of more patients being eligible for low-dose CT (LDCT) lung cancer screening. Sowmyanarayanan Thuppal, Southern Illinois University School of Medicine, USA, and lead researcher in the current study, highlighted that “the national screening rate for lung cancer is less than 6%,” in the USA, a figure that needs improvement.
Using patients from four family medicine physicians at the Southern Illinois University School of Medicine, this investigation analysed 451 former and current smokers, with a median age of 61 years, to determine if proactive patient education and recruitment impacts LDCT screening rates.
The cohort was split into two branches, one receiving proactive recruitment (prospective), and others who did not (retrospective). Patients were grouped based on smoking status and pack-years to assess if they qualified for screening, and the results noted how many participated in screening within a year.
Thuppal explained: “Our nurse navigator called each patient to assess eligibility and confirm their smoking history.” This prospective phase demonstrated a 37.3% increase in patients eligible versus the retrospective phase reliant upon electronic medical records granting eligibility.
In the section without proactive recruitment and education, researchers identified 184 (41%) eligible patients, but only 34 (19%) ordered for LDCT. The cohort who spoke to a navigator was made up of 206 patients, and 122 (59%) of these expressed interest in screening by agreeing over the phone, leading to 42 (20%) ordering LDCT.
This study observed that patients receiving education over the phone had more LDCTs ordered, and lesions detected, than patients who did not. Problems highlighted by this work, to be tackled in the near future, include, “the need for additional physician time and staffing to discuss LDCT, and for shared decision making,” in the words of Thuppal. Future study is warranted investigating nurse navigation and telehealth as tools for improving lung cancer screening rates in high-risk individuals.
