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Grant Details

Grant Number: 5R01CA249506-03 Interpret this number
Primary Investigator: Braithwaite, Dejana
Organization: University Of Florida
Project Title: Personalized Screening for Lung Cancer: the Importance of CO-Existing Chronic Conditions to Clinical Practice and Policy
Fiscal Year: 2022


Abstract / summary Lung cancer is the leading cause of cancer death in the US and worldwide, largely because most patients have advanced, incurable disease at the time of diagnosis. However, lung cancer screening (LCS) with low-dose computed tomography (LDCT) has the potential to revolutionize lung cancer outcomes through early detection. As LCS is disseminated into real-world settings and populations, a key outstanding question is whether the benefits/harms ratio found in clinical trials will apply to an older and sicker population. The basic conundrum facing LCS candidates is that the single risk factor most strongly linked to lung cancer -- smoking history -- is also strongly linked to morbidity and death from non-lung cancer causes (e.g. chronic obstructive pulmonary disease emphysema), which limit life expectancy and increase risk of complications from diagnostic or therapeutic procedures. The overarching goal of our proposed study is to precisely characterize this vulnerable subpopulation with high comorbidity burden, quantifying for them the benefits and harms of LCS to enable more informed decision-making by patients contemplating LCS. Our study will help close this knowledge gap by leveraging real-world data to more fully characterize this subpopulation of “marginal” LCS candidates, reducing the uncertainty currently facing patients and providers. More specifically, we propose to leverage electronic health records and claims data for patients ages 55-80 (n~34,039) undergoing annual screening with LDCT in geographically diverse real-world settings from 2016-2022. We will then use these observational data with validated models in the Cancer Intervention Simulation Network to simulate LCS outcomes in the real-world US population. By generating previously unavailable real-world data for use in validated simulation models, this proposal responds directly to calls to improve patient- centered decision-making in LCS candidates for whom the net benefits of screening are currently highly uncertain.


The Intersectionality between Race, Ethnicity, and Residential-Level Socioeconomic Status in Disparities of Head and Neck Cancer Outcomes: A SEER Study.
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Source: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2023-04-03; 32(4), p. 516-523.
PMID: 36780193
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Survival Differences by Comorbidity Burden among Patients with Stage I/II Non-Small-Cell Lung Cancer after Thoracoscopic Resection.
Authors: Wheeler M. , Karanth S.D. , Mehta H.J. , Yang D. , Aduse-Poku L. , Washington C. , Hong Y.R. , Zhang D. , Gould M.K. , Braithwaite D. .
Source: Cancers, 2023-03-30; 15(7), .
EPub date: 2023-03-30.
PMID: 37046735
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A predictive model for lung cancer screening nonadherence in a community setting health-care network.
Authors: Bastani M. , Chiuzan C. , Silvestri G. , Raoof S. , Chusid J. , Diefenbach M. , Cohen S.L. .
Source: JNCI cancer spectrum, 2023-03-01; 7(2), .
PMID: 37027213
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Personalised Lung Cancer Screening (PLuS) study to assess the importance of coexisting chronic conditions to clinical practice and policy: protocol for a multicentre observational study.
Authors: Braithwaite D. , Karanth S.D. , Slatore C.G. , Zhang D. , Bian J. , Meza R. , Jeon J. , Tammemagi M. , Schabath M. , Wheeler M. , et al. .
Source: BMJ open, 2022-06-22; 12(6), p. e064142.
EPub date: 2022-06-22.
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Cancer and aging: A call to action.
Authors: Braithwaite D. , Anton S. , Mohile S. , DeGregori J. , Gillis N. , Zhou D. , Bloodworth S. , Pahor M. , Licht J. .
Source: Aging and cancer, 2022 Jun; 3(2), p. 87-94.
EPub date: 2022-07-12.
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Expansion of Guideline-Recommended Lung Cancer Screening Eligibility: Implications for Health Equity of Joint Screening and Cessation Interventions.
Authors: Salloum R.G. , Braithwaite D. .
Source: Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2022 Jan; 17(1), p. 13-15.
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