Skip to main content
Grant Details

Grant Number: 1R01CA249506-01 Interpret this number
Primary Investigator: Braithwaite, Dejana
Organization: Georgetown University
Project Title: Personalized Screening for Lung Cancer: the Importance of CO-Existing Chronic Conditions to Clinical Practice and Policy
Fiscal Year: 2020


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.


Patient-Provider Discussion About Lung Cancer Screening by Race and Ethnicity: Implications for Equitable Uptake of Lung Cancer Screening.
Authors: Hong Y.R. , Wheeler M. , Wang R. , Karanth S. , Yoon H.S. , Meza R. , Kaye F. , Bian J. , Jeon J. , Gould M.K. , et al. .
Source: Clinical lung cancer, 2024 Jan; 25(1), p. 39-49.
EPub date: 2023-08-18.
PMID: 37673782
Related Citations

Beyond the AJR: Should Imaging-Based Risk Assessment Tools Be Used in Lung Cancer Screening?
Authors: Hochhegger B. , Braithwaite D. .
Source: AJR. American journal of roentgenology, 2023 Sep; 221(3), p. 390.
EPub date: 2023-02-01.
PMID: 36722762
Related Citations

Creating Opportunities to Eliminate Disparities in Lung Cancer Outcomes: A Call for Diverse Study Populations. Comment on Kohan et al. Disparity and Diversity in NSCLC Imaging and Genomics: Evaluation of a Mature, Multicenter Database. Cancers 2023, 15, 2096.
Authors: Washington C.J. , Braithwaite D. .
Source: Cancers, 2023-07-25; 15(15), .
EPub date: 2023-07-25.
PMID: 37568577
Related Citations

Allostatic load and risk of all-cause, cancer-specific, and cardiovascular mortality in older cancer survivors: an analysis of the National Health and Nutrition Examination Survey 1999-2010.
Authors: Yang D. , Wheeler M. , Karanth S.D. , Aduse-Poku L. , Leeuwenburgh C. , Anton S. , Guo Y. , Bian J. , Liang M. , Yoon H.S. , et al. .
Source: Aging and cancer, 2023 Jun; 4(2), p. 74-84.
EPub date: 2023-05-15.
PMID: 37576467
Related Citations

Cancer incidence after asthma diagnosis: Evidence from a large clinical research network in the United States.
Authors: Guo Y. , Bian J. , Chen Z. , Fishe J.N. , Zhang D. , Braithwaite D. , George T.J. , Shenkman E.A. , Licht J.D. .
Source: Cancer medicine, 2023 May; 12(10), p. 11871-11877.
EPub date: 2023-03-31.
PMID: 36999938
Related Citations

The Intersectionality between Race, Ethnicity, and Residential-Level Socioeconomic Status in Disparities of Head and Neck Cancer Outcomes: A SEER Study.
Authors: Karanth S.D. , Akinyemiju T. , Walker C.J. , Yang D. , Migliorati C.A. , Yoon H.S. , Hong Y.R. , Washington C.J. , Lattimore C. , Fredenburg K.M. , et al. .
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
Related Citations

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
Related Citations

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
Related Citations

Is Lung Cancer Screening Reaching the People Who Are Most Likely to Benefit?
Authors: Braithwaite D. , Gould M.K. .
Source: JAMA network open, 2022-11-01; 5(11), p. e2243171.
EPub date: 2022-11-01.
PMID: 36409500
Related Citations

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.
PMID: 35732383
Related Citations

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.
PMID: 36188489
Related Citations

A Preliminary Study of Extracting Pulmonary Nodules and Nodule Characteristics from Radiology Reports Using Natural Language Processing.
Authors: Yang S. , Yang X. , Lyu T. , He X. , Braithwaite D. , Mehta H.J. , Guo Y. , Wu Y. , Bian J. .
Source: IEEE International Conference on Healthcare Informatics. IEEE International Conference on Healthcare Informatics, 2022 Jun; 2022, p. 618-619.
EPub date: 2022-09-08.
PMID: 36168559
Related Citations

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.
PMID: 34930605
Related Citations

Comorbidity Profiles and Lung Cancer Screening among Older Adults: U.S. Behavioral Risk Factor Surveillance System 2017-2019.
Authors: Advani S. , Zhang D. , Tammemagi M. , Akinyemiju T. , Gould M.K. , Silvestri G.A. , Braithwaite D. .
Source: Annals of the American Thoracic Society, 2021 Nov; 18(11), p. 1886-1893.
PMID: 33939595
Related Citations

The role of sex and rurality in cancer fatalistic beliefs and cancer screening utilization in Florida.
Authors: Guo Y. , Szurek S.M. , Bian J. , Braithwaite D. , Licht J.D. , Shenkman E.A. .
Source: Cancer medicine, 2021 Sep; 10(17), p. 6048-6057.
EPub date: 2021-07-13.
PMID: 34254469
Related Citations

Back to Top