The reporting of pulmonary nodule results by letter in a lung cancer screening setting

Dickson, Jennifer; Bhamani, Amyn; Quaife, Samantha L; Horst, Carolyn; Tisi, Sophie; Hall, Helen; Verghese, Priyam; Creamer, Andrew; Prendecki, Ruth; McCabe, John P.; Gyertson, Kylie; Bowyer, Vicky; El-Emir, Ethaar; Cotton, Alice; Mehta, S.; Bojang, Fanta; Levermore, Claire; Mullin, Anne; Teague, Jonathan; Farrelly, Laura; Nair, Arjun; Devaraj, Anand; Hackshaw, Allan; Janes, Sam M.

doi:10.1016/j.lungcan.2022.04.009

Cited by 8 publications

(12 citation statements)

References 8 publications

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“…4,10 While our review results suggest patient-clinician contact during result disclosure is preferred, recent data from a real-world sample in the UK found that most participants who had nodules requiring a 3-month follow-up scan favoured receiving results via letter (noting that patients had opportunities for face-to-face discussion with a clinician before their repeat scan). 56 This suggests that the opportunity for a single, high-quality discussion at some point during LCS may mitigate the need for communicating results inperson or continued patient-clinician interaction, when considering ways to manage psychological burden during LCS. Supplemental information such as a "commonly asked questions" sheet 19 as part of LDCT result communication may be effective in supporting participants' knowledge and understanding, while avoiding implementation challenges related to personalised communication (e.g., extra logistics, privacy concerns).…”

Section: Ldct Results Communicationmentioning

confidence: 99%

“…There is a lack of evidence about the most effective ways for clinicians to communicate LCS results (and for other types of cancer screening) in a way that minimises psychological burden, in particular anxiety 4,10 . While our review results suggest patient‐clinician contact during result disclosure is preferred, recent data from a real‐world sample in the UK found that most participants who had nodules requiring a 3‐month follow‐up scan favoured receiving results via letter (noting that patients had opportunities for face‐to‐face discussion with a clinician before their repeat scan) 56 . This suggests that the opportunity for a single, high‐quality discussion at some point during LCS may mitigate the need for communicating results in‐person or continued patient‐clinician interaction, when considering ways to manage psychological burden during LCS.…”

Section: Discussionmentioning

confidence: 99%

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Lung cancer screening program factors that influence psychosocial outcomes: A systematic review

McFadden,

Rankin,

Nickel

et al. 2023

Psycho-Oncology

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ObjectivesLung cancer screening (LCS) programs are being designed and implemented globally. Early data suggests that the psychosocial impacts of LCS are influenced by program factors, but evidence synthesis is needed. This systematic review aimed to elucidate the impact of service‐level factors on psychosocial outcomes to inform optimal LCS program design and future implementation.MethodsFour databases were searched from inception to July 2023. Inclusion criteria were full‐text articles published in English that reported an association between any program factors and psychosocial outcomes experienced during LCS. Study quality was appraised, and findings were synthesised narratively.ResultsThirty‐two articles were included; 29 studies were assessed at high or moderate risk of bias. Study designs were RCT (n = 3), pre‐post (n = 6), cross‐sectional (n = 12), mixed‐methods (n = 1), and qualitative (n = 10) studies, and conducted primarily in the USA (n = 25). Findings suggested that targeted interventions can improve smoking‐related or decisional psychosocial outcomes (e.g., smoking cessation interventions increase readiness/motivation to quit) but impacts of interventions on other psychological outcomes were varied. There was limited evidence reporting association between service delivery components and psychological outcomes, and results suggested moderation by individual aspects (e.g., expectation of results, baseline anxiety). Opportunities for discussion were key in reducing psychological harm.ConclusionsCertain program factors are reportedly associated with psychosocial impacts of LCS, but study heterogeneity and quality necessitate more real‐world studies. Future work should examine (a) implementation of targeted interventions and high‐value discussion during LCS, and (b) optimal methods and timing of risk and result communication, to improve psychosocial outcomes while reducing time burden for clinicians.

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Section: Ldct Results Communicationmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Lung cancer screening program factors that influence psychosocial outcomes: A systematic review

McFadden,

Rankin,

Nickel

et al. 2023

Psycho-Oncology

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“…Finally, Prof. Janes talked about the SUMMIT study (NCT03934866) in which the objectives were twofold; to assess the feasibility of LDCT screening of a large metropolitan population and to assess the accuracy of a blood biomarker for multiple cancers. Despite road blocks to success like COVID-19 and historically poor uptake and retention of patients in lung screening trials in general [ 9 ], the SUMMIT study has recently reported high patient satisfaction with the study [ 10 ].…”

Section: Early Detection and Diagnosismentioning

confidence: 99%

Precision Medicine and Novel Therapeutic Strategies in Detection and Treatment of Cancer: Highlights from the 58th IACR Annual Conference

Kennedy

Treacy

Allott

et al. 2022

Cancers

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Innovation in both detection and treatment of cancer is necessary for the constant improvement in therapeutic strategies, especially in patients with novel or resistant variants of cancer. Cancer mortality rates have declined by almost 30% since 1991, however, depending on the cancer type, acquired resistance can occur to varying degrees. To combat this, researchers are looking towards advancing our understanding of cancer biology, in order to inform early detection, and guide novel therapeutic approaches. Through combination of these approaches, it is believed that a more complete and thorough intervention on cancer can be achieved. Here, we will discuss the advances and approaches in both detection and treatment of cancer, presented at the 58th Irish Association for Cancer Research (IACR) annual conference.

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“…Blood-based screening using circulating tumor DNA (ctDNA) is a potential alternative to LDCT-based lung cancer screening [12][13][14][15][16][17] . Currently, two clinical trials are underway in the UK to evaluate the effectiveness of ctDNA detection as a multi-cancer early detection test 18,19 . Since such trials demand substantial resources and time, mathematical models that estimate the health outcomes of ctDNA detection can be valuable prediction tools.…”

Section: Introductionmentioning

confidence: 99%

Natural history model predicts benefits associated with screening for lung cancer by detecting circulating tumor DNA

Plevritis,

Simoni,

Avanzini

et al. 2023

Preprint

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Current US screening guidelines recommend low dose computed tomography (LDCT) scans for high-risk individuals of lung cancer, however, only 13% of the eligible population adhere to the recommendation. Using circulating tumor DNA (ctDNA) as a blood-based cancer biomarker for screening may increase the adherence to screening programs while simultaneously decreasing radiation exposure and invasive follow-up procedures due to false-positives of LDCT. To estimate the health benefits of annual lung cancer screening with ctDNA, we built and applied a multi scale model of the natural history of lung cancer that includes clinical stage progression and ctDNA shedding, and models ctDNA detection. Our multi-scale model integrates data on lung cancer including clinical data from the Surveillance, Epidemiology, and End Results (SEER) database and molecular data on tumor growth, ctDNA shedding and ctDNA detection. The ctDNA detection function is based on a sequencing panel enriched for recurrent point mutations associated with lung cancer and leverages The Cancer Genome Atlas (TCGA) data. Using the model, we generated individual patient trajectories in term of the natural history of lung cancer and aggregated the results at the population level to compare overall health outcomes in the presence vs absence of an annual ctDNA screening. These outcomes include the tumor size and stage at detection, 5-year survival, age-specific incidence-based mortality rate, and cure fraction, which is identified by patients who would have died from lung cancer but instead died from other causes due to screen detection. Our work shows that annual ctDNA screening detected 35% of lung cancer patients while asymptomatic with 99% specificity. Among screen-detected patients, 36% were curable due to early detection but would have been uncurable without screening. Compared to not screening, annual ctDNA screening reduced the median tumor size at detection (from 3.2 cm to 2.2 cm), increased the proportion of early-stage cases (from 36% to 56%), increased 5-year survival (from 20% to 33%), and reduced the average age-specific mortality rate by 21%. In conclusion, an annual ctDNA screening program, even with low sensitivity but high specificity, is expected to provide measurable health benefits and warrants further consideration

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The reporting of pulmonary nodule results by letter in a lung cancer screening setting

Cited by 8 publications

References 8 publications

Lung cancer screening program factors that influence psychosocial outcomes: A systematic review

Lung cancer screening program factors that influence psychosocial outcomes: A systematic review

Precision Medicine and Novel Therapeutic Strategies in Detection and Treatment of Cancer: Highlights from the 58th IACR Annual Conference

Natural history model predicts benefits associated with screening for lung cancer by detecting circulating tumor DNA

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