Q&A: Initiative aims to help more Maryland residents get screened for lung cancer

Key takeaways:

• Currently, only 3% of eligible Marylanders undergo low-dose CT.
• The University of Maryland Greenebaum Comprehensive Cancer Center and AstraZeneca have teamed up to help Marylanders at risk for lung cancer.

The risk for lung cancer has been found to be particularly high in some Maryland counties, but a recently launched initiative is making sure screening is available for all eligible state residents, according to a press release.

Through this initiative, the University of Maryland Greenebaum Comprehensive Cancer Center and AstraZeneca are determined to improve lung cancer screening rates in Maryland, educate residents on early detection and risk factors, and spread awareness on prevention efforts.

To learn more about the inspiration behind this initiative, details of what it seeks to address and its goals, Healio spoke with Taofeek K. Owonikoko, MD, PhD, executive director of the University of Maryland Greenebaum Comprehensive Cancer Center and Marlene and Stewart Greenebaum professor of oncology at the University of Maryland School of Medicine.

Healio: What inspired the development of this initiative?

Owonikoko: We saw a significant unmet need in Maryland. Lung cancer is curable if it is detected early, but only about 3% of Marylanders eligible to receive recommended annual low-dose CT screening are being screened. In order to increase screening statewide, we first need to educate people about the importance of screening to catch lung cancer early and who is at risk and should be screened. We see our efforts having the greatest impact in underserved communities, where people may not have awareness of and access to potentially lifesaving low-dose CT scans.

Healio: The press release notes higher rates of lung cancer in some Maryland counties compared with the national average. What makes these counties more susceptible to lung cancer?

Owonikoko: Preliminary data show that certain counties in Maryland have a higher rate of lung cancer than the national average, but at this point, we do not know why. Higher smoking rates may account for some of the higher rates, but other factors such as environmental pollution and radon exposure may also play a role. That is one of the things we will be studying as part of this initiative. With additional data and analysis, we may have a better understanding of what is causing increased rates of lung cancer in some counties.

Healio: How will this initiative benefit both those at risk for lung cancer and patients who are already diagnosed with lung cancer?

Owonikoko: The focus of our partnership with AstraZeneca is to increase early diagnosis through improved access to low-dose CT scans for those at risk for developing lung cancer while also promoting activities that aid in reducing the risk and prevention such as tobacco use cessation. We believe that this collaboration will enable us to reach many more people in Maryland who may not even realize that they are at risk.

Our plans to expand existing screening services will include a mobile screening van that will travel to communities throughout the state. We want to meet people where they live and work — provide a convenient alternative to going to a hospital. We also want to follow those people who may need additional tests based on the results of their scans.

As for patients already diagnosed with lung cancer, we have a robust multidisciplinary treatment program at the Greenebaum Comprehensive Cancer Center, where oncologists collaborate to develop a personalized treatment plan for each patient. Our physicians can see patients and together with the patient and family craft the best treatment plan appropriate for the stage of their cancer.

Healio: This initiative involves strengthening tobacco cessation efforts. Why is it important to consider smoking when aiming to increase annual lung cancer screening?

Owonikoko: Smoking tobacco is the No. 1 cause of lung cancer, so educating people on the dangers of smoking and helping them to quit using tobacco products is the most effective way to prevent lung cancer. The benefits of quitting are well documented, with almost immediate benefits not only to the lungs and cardiovascular system but also an individual’s overall health. Stopping smoking helps to prevent cardiovascular and lung disease and other cancers in addition to lung cancer.

Healio: What types of technology are you looking into/using for identification of patients who could benefit from screening?

Owonikoko: We are still evaluating the resources available to us to implement this 5-year collaboration with AstraZeneca. But chief among them will be the University of Maryland Institute for Health Computing (UM-IHC) and the State Health Information Exchange, called CRISP, which will enable us to leverage technology to better understand the large population of people who are eligible for screening. In partnership with our colleagues at the University of Maryland, College Park and other outside institutions, we will also be deploying some of the emerging platforms and advanced techniques in automated image analysis and AI to facilitate large-scale reading of the scans.

Healio: What efforts are currently in place to help minority and rural communities access cancer screening and treatments? How does this initiative build on these efforts?

Owonikoko: Our cancer center’s Community Outreach and Engagement Program helps to provide cancer screening and education to Baltimore City and 10 surrounding counties in Central Maryland with a population of about 5.4 million. About 32% of the population is African American and 11% Hispanic/Latino. The center’s Baltimore City Cancer Program provides breast, cervical and colon cancer screening. As part of this new initiative, low-dose CT scans for lung cancer will also be available. The program, which serves a largely Hispanic/Latino population, has provided cancer screenings for uninsured and underinsured city residents for nearly 23 years.

Six hospitals within the University of Maryland Medical System offer low-dose CT lung cancer screenings. They include the flagship University of Maryland Medical Center in Baltimore City, where our cancer center is located, and University of Maryland Shore Regional Health in Easton, which serves five counties on Maryland’s predominantly rural Eastern Shore.

Healio: What do you hope to achieve in the short-term and long-term future with this initiative?

Owonikoko: In the short-term, we want to increase awareness of who should be screened for lung cancer and where they can be screened. People cannot avail themselves of existing screening services if they do not know that they need to be screened or where to go. Thus, education is vitally important to increasing the percentage of eligible Maryland residents who are screened each year. We can also make screening more accessible in the near term by establishing a mobile CT screening program, with a van that travels to communities of highest risk throughout the state.

It is also important to improve follow-up care, and we propose to open a dedicated clinic in our cancer center where people can come for additional tests and, if necessary, treatment. Follow-up is key to making sure that people do not fall through the cracks if a low-dose CT scan discovers something suspicious.

Our partnership with AstraZeneca will jumpstart our efforts to build a comprehensive, all-inclusive statewide cancer screening program to ensure that all eligible Maryland residents undergo timely and cost-effective cancer screening. We are starting with lung cancer screening but hope to achieve our long-term goal by boosting screening for other cancers in the future.

We hope to learn a lot from this initiative and part of our goal is to share the lessons learned from this partnership with other health care systems around the country.

Healio: How will you aim to achieve success with this initiative?

Owonikoko: For us to be successful in this initiative, we will be counting on the support and engagement of the University of Maryland Greenebaum Comprehensive Cancer Center community advisory board members and other key stakeholders (individuals, government agencies and private establishments) in the various communities that we serve.

We will also set up a group of external advisors to provide critical feedback and assess our performance to ensure that we remain focused on the task. At the end of the 5-year period, we set our goal at increasing the number of eligible Marylanders undergoing low-dose CT from the current 3% to about 25% to 30%.

Reference:

• University of Maryland Greenebaum Comprehensive Cancer Center and AstraZeneca partner to enhance community-based lung cancer screening and detection for Marylanders at high risk. https://www.umms.org/umgccc/news/2024/umgccc-partners-with-astrazeneca. Published April 16, 2024. Accessed April 19, 2024.