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Lung cancer roundtable to promote screening access, further research agenda
The American Cancer Society — together with leading professional, government and nongovernmental organizations — launched the National Lung Cancer Roundtable to accelerate efforts to reduce lung cancer mortality in the United States.
Lung cancer is the leading cause of cancer mortality in the United States. An estimated 158,000 Americans died of lung cancer last year, and the malignancy accounts for one in four cancer deaths annually, according to ACS.
The roundtable — which will be chaired by Ella A. Kazerooni, MD, MS, FACR — is designed to ensure that people at high risk for lung cancer have access to screening and receive timely, patient-centered, state-of-the-art lung cancer care.
“I look forward to shaping a future through this collaboration, where a diagnosis of lung cancer is no longer received as a death sentence but instead — when caught early through screening — becomes a treatable and survivable cancer,” Kazerooni, chair of the American College of Radiology Lung Cancer Screening Committee and Thoracic Imaging Panel, said in a press release.
HemOnc Today spoke with Kazerooni about the roundtable’s mission and the impact she hopes it will have on lung cancer care.
Question: How did the roundtable come about?
Answer: A 2-year span of tremendous advocacy efforts from professional provider organizations and patient advocacy groups followed the U.S. Preventive Services Task Force’s recommendation to ensure the availability of coverage for lung cancer screening for those who met specific age and smoking history criteria. Nearly 180 organizations came together on common goals so that we could move forward with lung cancer screening. The next step seemed quite natural: to leverage all of the relationships built through the advocacy process and move forward with ACS’s efforts to implement screening safely and effectively. As part of the discussions that the core organizations and our advocacy efforts had with CMS, it appeared very clear that CMS is interested in ensuring this collaboration.
Q: Who are the roundtable participants?
A: The roundtable is modeled after the successful ACS Colorectal Cancer Roundtable. A steering committee will identify focused topics for working groups, plan our annual roundtable event to bring together parties across the spectrum of interest in lung cancer screening, and ensure that educational materials are developed to reach patients and providers. Steering committee members include physicians in primary care, radiology, thoracic surgery and pulmonary medicine, experts in smoking cessation and patient advocacy, and representatives from CMS.
Q: How were the representatives selected?
A: These individuals implement screening programs, and they have hands-on experience with counseling and bringing patients to lung cancer screening. They have leveraged the ACS’s pre-existing tobacco cessation efforts and have brought individuals from the CMS coverage group to the roundtable. Members of the group have worked toward identifying other members from the NIH in order to understand the science better and ensure that lung cancer screening is safe and effective. Broader roundtable participant organizations will be expanded across disciplines, including experts in shared decision-making, lung cancer biomarkers and advances in the treatment of early lung cancer, as well as health insurers and imaging vendors, to ensure we are reaching a wide audience.
Q: How did you become chair of the roundtable?
A: I became chair through my advocacy efforts and by bringing people and organizations together in seeking coverage, as well as developing quality tools for radiology practices to begin screening safely and with high quality.
Q: What are the roundtable’s priorities?
A: The National Lung Cancer Roundtable is expected to collaborate on issues related to best practices for lung cancer screening and testing, insurance coverage requirements and costs, and policy requirements. We will aim to push broad implementation of screening, increase uptake across the country, identify which patients should be screened, determine how to manage the positive screens and treat early lung cancer effectively, and further tobacco cessation efforts across the country. The last component is to assess whether we are reducing lung cancer mortality. To accomplish all of this, we need to leverage the strengths of all members of the steering committee and the participants in the roundtable by partnering with organizations who have infrastructure from which we can learn. To this end, the American College of Radiology has the only CMS–approved lung cancer screening registry; we will make suggestions about how and when the data are analyzed so we can see how screening is faring in practice. We will identify where screening is not occurring and do more outreach to get screening to those areas. As we start to increase the proportion of lung cancers diagnosed at an earlier stage, it will be important to focus on the status of early lung cancer treatments.
Q: What has been accomplished so far?
A: At our first meeting, we narrowed down topics and began to form working groups. These groups will issue white papers on the status and future needs of those areas. By the end of this year, we will have our first large-scale National Lung Cancer Screening Roundtable. We will invite organizations that have an aligned interest in lung cancer screening, so we can have a dialogue that reaches more organizations. Several task groups will work on all priority areas.
Q: What is the potential impact of this initiative?
A: I hope we will ensure that lung cancer screening is being implemented and that all at-risk individuals have access to screening. We aim to further the research agenda in all aspects of lung cancer screening, because there is a lot we still do not know. Unlike breast cancer screening — which is fairly mature and advanced — we are in our infancy with lung cancer screening. My hope is that this roundtable will push research efforts forward and ensure we are screening the right patients. We only use age and smoking criteria to identify at-risk individuals, but there are other ways to better identify those at risk for lung cancer.
Q: Is there anything else that you would like to mention?
A: It is an honor to have been asked to chair the National Lung Cancer Roundtable and to work with such a tremendous group of people who are participating in our steering committee. They are a highly motivated group of professionals who all want to see lung cancer screening implemented so it can reach those at highest risk. I am truly looking forward to what we are going to be able to do with this roundtable and the ACS. – by Jennifer Southall
For more information:
Ella A. Kazerooni, MD, MS, FACR, can be reached at The American College of Radiology, 1891 Preston White Drive, Reston, VA 20191; email: ellakaz@umich.edu.
Disclosure: Kazerooni reports no relevant financial disclosures.