Grant Number:	5R01CA212014-07 Interpret this number
Primary Investigator:	Henderson, Louise
Organization:	Univ Of North Carolina Chapel Hill
Project Title:	Evaluating Lung Cancer Screening Patterns and Outcomes in Diverse Populations and Settings
Fiscal Year:	2024

ABSTRACT Lung cancer is the leading cause of cancer deaths in the United States, with higher rates of lung cancer among Black versus White men, despite Black populations having lower smoking rates, smoking fewer cigarettes per day, and being less likely to smoke heavily. Randomized trials demonstrated early detection of lung cancer with annual low dose computed tomography reduces lung cancer mortality by 20-33% in high-risk populations. In 2013 the US Preventive Services Task Force (USPSTF) recommended annual lung cancer screening (LCS) in individuals ages 55-80 years who currently or former (quit within 15 years) smoked at least 30 pack-years. Some studies suggested the 2013 USPSTF LCS eligibility criteria under selected women and Black individuals who tend to smoke less intensely yet have increased risk of developing lung cancer. In 2021, the USPSTF expanded their LCS recommendations to include individuals ages 50-80 years with at least a 20 pack-year history, increasing the number eligible by more than 80% to 14.5 million U.S. adults. These expanded criteria will result in higher relative increases in screening eligibility for women versus men and non-Hispanic Black versus non-Hispanic White populations. Yet, the impact of the expanded 2021 USPSTF eligibility criteria on screening practice and outcomes is unknown. The objective of this application is to understand how the updated 2021 USPSTF LCS recommendations are implemented in practice and quantify the impact of the new recommendations on the LCS care continuum from adherence to performance. Our central hypothesis is that there will be race and sex-based differences in the benefits and harms of LCS among newly eligible individuals (e.g., ages 50-54 years or smoking 20-29 P-Y) because of heterogeneity in the baseline risk of developing lung cancer. Guided by strong preliminary data, the hypothesis will be tested by pursuing the following specific aims: 1) Evaluate patients’ and clinicians' attitudes, knowledge, and experiences with the expanded 2021 USPSTF LCS recommendations; 2) Determine the impact of the 2013 vs. 2021 USPSTF LCS eligibility criteria across the screening care continuum in terms of (a) baseline lung cancer risk in the population screened, (b) adherence to annual LCS, and (c) receipt of recommended care following an abnormal LCS result; and 3) Compare the performance of LDCT LCS in individuals screened per the USPSTF 2013 criteria versus the 2021 newly eligible criteria. The study is innovative in combining survey and quantitative methods in a large, diverse, community-based population to evaluate the impact of the 2021 USPSTF LCS recommendations on LCS care patterns and outcomes. The proposed research is significant because it will quantify the experiences of LCS in the 14.5 million individuals now eligible for screening. The findings are expected to advance and expand our understanding of LCS in diverse populations and settings which will enable clinicians to deliver more evidence based, high-quality LCS care.




Estimating the Effects of Cancer Screening in Clinical Practice Settings: The Role of Selective Uptake and Suboptimal Adherence along the Cancer Screening Continuum.
Authors: Lund J.L. , Rivera M.P. , Su I.H. , Long J.M. , Chen X. , Pak J. , Hudgens M.G. , Stürmer T. , Reuland D.S. , Henderson L.M. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2024-08-01 00:00:00.0; 33(8), p. 984-988.
PMID: 39012954
Related Citations

Prevalence of Lung Cancer Screening in the US, 2022.
Authors: Henderson L.M. , Su I.H. , Rivera M.P. , Pak J. , Chen X. , Reuland D.S. , Lund J.L. .
Source: Jama Network Open, 2024-03-04 00:00:00.0; 7(3), p. e243190.
EPub date: 2024-03-04 00:00:00.0.
PMID: 38512257
Related Citations

Delays in Follow-up after a Positive Lung Cancer Screening Exam: Is the Benefit of Screening Compromised?
Authors: Rivera M.P. , Henderson L.M. , Sakoda L.C. .
Source: Annals Of The American Thoracic Society, 2023 Aug; 20(8), p. 1102-1104.
PMID: 37311217
Related Citations

Communication of Positive Lung Cancer Screening Findings and Receipt of Recommended Follow-up Care.
Authors: Henderson L.M. , Durham D.D. , Long J. , Lamb D. , Lane L.M. , Rivera M.P. .
Source: Jama Network Open, 2023-06-01 00:00:00.0; 6(6), p. e2320409.
EPub date: 2023-06-01 00:00:00.0.
PMID: 37347487
Related Citations

Variability in Reporting of Incidental Findings Detected on Lung Cancer Screening.
Authors: Henderson L.M. , Chiles C. , Perera P. , Durham D.D. , Lamb D. , Lane L.M. , Rivera M.P. .
Source: Annals Of The American Thoracic Society, 2022-12-20 00:00:00.0; , .
EPub date: 2022-12-20 00:00:00.0.
PMID: 36538683
Related Citations

Lung Cancer Screening in Individuals With and Without Lung-Related Comorbidities.
Authors: Metwally E.M. , Rivera M.P. , Durham D.D. , Lane L. , Perera P. , Lamb D. , Henderson L.M. .
Source: Jama Network Open, 2022-09-01 00:00:00.0; 5(9), p. e2230146.
EPub date: 2022-09-01 00:00:00.0.
PMID: 36066893
Related Citations

Prospective Multisite Cohort Study to Evaluate Shared Decision Making Utilization Among Individuals Screened for Lung Cancer.
Authors: Tailor T. , Rivera M.P. , Durham D.D. , Perera P. , Lane L. , Henderson L.M. .
Source: Journal Of The American College Of Radiology : Jacr, 2022-04-16 00:00:00.0; , .
EPub date: 2022-04-16 00:00:00.0.
PMID: 35439440
Related Citations

Adherence to Lung Cancer Screening: What Exactly Are We Talking About?
Authors: Sakoda L.C. , Henderson L.M. , Rivera M.P. .
Source: Annals Of The American Thoracic Society, 2021 12; 18(12), p. 1951-1952.
PMID: 34380008
Related Citations

Randomized control trial of unconditional versus conditional incentives to increase study enrollment rates in participants at increased risk of lung cancer.
Authors: Kumar A.D. , Durham D.D. , Lane L. , Perera P. , Rivera M.P. , Henderson L.M. .
Source: Journal Of Clinical Epidemiology, 2021-08-29 00:00:00.0; 141, p. 11-17.
EPub date: 2021-08-29 00:00:00.0.
PMID: 34469801
Related Citations

Lung Cancer Screening With Low Dose Computed Tomography in Patients With and Without Prior History of Cancer in the National Lung Screening Trial.
Authors: Henderson L.M. , Durham D.D. , Tammemägi M.C. , Benefield T. , Marsh M.W. , Rivera M.P. .
Source: Journal Of Thoracic Oncology : Official Publication Of The International Association For The Study Of Lung Cancer, 2021 Jun; 16(6), p. 980-989.
EPub date: 2021-02-10 00:00:00.0.
PMID: 33581343
Related Citations

Patterns and Factors Associated With Adherence to Lung Cancer Screening in Diverse Practice Settings.
Authors: Sakoda L.C. , Rivera M.P. , Zhang J. , Perera P. , Laurent C.A. , Durham D. , Huamani Velasquez R. , Lane L. , Schwartz A. , Quesenberry C.P. , et al. .
Source: Jama Network Open, 2021-04-01 00:00:00.0; 4(4), p. e218559.
EPub date: 2021-04-01 00:00:00.0.
PMID: 33929519
Related Citations

Cardiovascular Risk in the Lung Cancer Screening Population: A Multicenter Study Evaluating the Association Between Coronary Artery Calcification and Preventive Statin Prescription.
Authors: Tailor T.D. , Chiles C. , Yeboah J. , Rivera M.P. , Tong B.C. , Schwartz F.R. , Benefield T. , Lane L.M. , Stashko I. , Thomas S.M. , et al. .
Source: Journal Of The American College Of Radiology : Jacr, 2021-02-26 00:00:00.0; , .
EPub date: 2021-02-26 00:00:00.0.
PMID: 33640340
Related Citations

Impact of the Coronavirus Disease 2019 Pandemic on Volumes and Disparities in Lung Cancer Screening.
Authors: Henderson L.M. , Benefield T. , Bosemani T. , Long J.M. , Rivera M.P. .
Source: Chest, 2021-01-05 00:00:00.0; , .
EPub date: 2021-01-05 00:00:00.0.
PMID: 33417898
Related Citations

Rates of positive lung cancer screening examinations in academic versus community practice.
Authors: Henderson L.M. , Bacchus L. , Benefield T. , Huamani Velasquez R. , Rivera M.P. .
Source: Translational Lung Cancer Research, 2020 Aug; 9(4), p. 1528-1532.
PMID: 32953524
Related Citations

Disparities in Lung Cancer Screening: A Review.
Authors: Haddad D.N. , Sandler K.L. , Henderson L.M. , Rivera M.P. , Aldrich M.C. .
Source: Annals Of The American Thoracic Society, 2020 Apr; 17(4), p. 399-405.
PMID: 32017612
Related Citations

Changes in Physician Knowledge, Attitudes, Beliefs, and Practices Regarding Lung Cancer Screening.
Authors: Henderson L.M. , Benefield T.S. , Bearden S.C. , Reuland D.S. , Brenner A.T. , Goldstein A.O. , Throneburg A. , Rivera M.P. .
Source: Annals Of The American Thoracic Society, 2019-05-10 00:00:00.0; , .
EPub date: 2019-05-10 00:00:00.0.
PMID: 31075047
Related Citations

Lung cancer screening and shared decision making in cancer survivors: the long and winding road.
Authors: Rivera M.P. , Henderson L.M. .
Source: Translational Lung Cancer Research, 2019 Apr; 8(2), p. 119-123.
PMID: 31106122
Related Citations