By engaging the community in identifying their friends and family members who may be eligible for lung cancer screening, we can increase the number of high-risk individuals who get screened.
Chi-Fu Jeffrey Yang, M.D.
Thoracic Surgeon, Massachusetts General Hospital, Associate Professor of Surgery, Harvard Medical School; Founder, American Lung Cancer Screening Initiative (ALCSI)
Lung cancer is the leading cause of cancer death in the United States. Currently, nearly half of all lung cancers are diagnosed at a late stage, where the survival rates are lowest. Diagnosing lung cancer at an early stage can increase survival rates significantly, with patients diagnosed with the earliest stage of lung cancer having a 5-year survival rate of over 80%. Screening for lung cancer is one way to find lung cancer at an early stage. Low-dose computed tomography (LDCT) scans are a reliable way to screen for lung cancer, yet only 16% of those eligible are actually screened.
Increasing awareness and accessibility
Breast cancer screening, colon cancer screening, and cervical cancer screening are now routinely discussed as a part of people’s annual medical exams. People are regularly reminded, at certain ages, to be sure to obtain screening for these cancers. Lung cancer screening should be as routine as other screenings and part of annual physicals, as long as eligibility requirements are met. My colleagues and I estimate that for every 320 screenings conducted, a life is saved. Lung cancer screening does save lives.
Unfortunately, the current lung cancer screening eligibility criteria, which include both age and tobacco use history, are more complicated compared to the eligibility criteria for other cancer screenings (based only on age requirements) and can be difficult to implement. Additionally, this focus on tobacco use as a lung cancer screening eligibility criterion may contribute to low levels of screening among those eligible to receive it. The stigma associated with smoking, especially as a risk factor for lung cancer, is one of the many barriers to increasing the uptake of lung cancer screening.
Identifying high-risk individuals
When I founded the American Lung Cancer Screening Initiative (ALCSI) in 2018, my goal was to teach community members about lung cancer screening and help those at high risk get screened. Our organization, led by all volunteers, raises awareness for lung cancer screening and helps connect community members to their local lung cancer screening centers. To date, ALCSI has taught over 30,000 community members about lung cancer screening.
Most recently, ALCSI is partnering with the Lung Cancer Research Foundation (LCRF) on a new initiative designed to combat the stigma associated with lung cancer screening, called the ”Plus One” campaign. This initiative is both an awareness campaign and a research project, designed to increase awareness of lung cancer screening by asking people if someone they know (the ”plus one”) may be eligible to be screened and providing them with information about where to get screened, as well as information and resources about screening for lung cancer, risk factors, and other important lung cancer resources and information. ALCSI volunteers are continuing to hold community events, where screening information is shared alongside resources and materials provided by LCRF.
We think that asking the question ”Do you know someone who may be eligible for lung cancer screening?” will be more effective in getting people screened because it removes the stigma that often accompanies directly asking someone if they themselves are eligible. Ultimately, our hope is that by engaging the community in identifying their friends and family members who may be eligible for screening, we can increase the number of high-risk individuals who get screened.
Making a change
The impact that the Plus One campaign has had already is encouraging. Between April and August of this year, ALCSI volunteers have actively held more than 700 community events, resulting in thousands of conversations about lung cancer screening with community members. About 1 in every 2 individuals knows someone who may be eligible for screening and is willing to share information about screening with that person.
It is our hope that this effort will increase awareness of the importance of lung cancer screening, help normalize lung cancer screening, and, ultimately, increase the number of high-risk individuals who undergo lung cancer screening.
To get more information about lung cancer screening, visit LCRF.org/screening. To learn more about ALCSI’s Plus One campaign, visit ALCSI.org/plus-one-campaign.
