Choose breath, not death: Improving lung cancer screening in the Christus Good Shepherd internal medicine resident clinic.

Abstract

e23231 Background: Lung Cancer is by far the leading cause of cancer death, making up almost 25% of all cancer deaths. Shockingly, each year more people die of lung cancer than colon, breast, and prostate cancers combined. Due to the late diagnosis, usually in the metastatic phase, the mortality is poor with more than half of patients dying within one year of diagnosis. Texas is 43rd in the nation in diagnosing lung cancer at an early stage. On a national level, approximately 5.8% of patients at high risk for lung cancer are screened, while in Texas, only 1.8% of all high-risk patients undergo screening. Furthermore, in East Texas, the rates of smoking and lung cancer are the highest in the entire state of Texas. In this quality improvement project, we sought to improve rates of lung cancer screening by raising awareness about the significance of lung cancer, addressing knowledge gaps about lung cancer screening guidelines, and educating physicians about how to have these life-saving conversations with patients. Methods: A retrospective analysis was performed from the quarterly CHRISTUS Good Shepherd Internal Medicine Resident Clinic lung cancer screening metrics using our EPIC electronic medical records from September 2022 to February 2024. The lung cancer screening metric reflects the calculated the percentage of patients age 50-77 who are on the smoking risk history registry who have had a lung cancer screening exam within the last year. Our intervention consisted of multiple sessions of in person and virtual lectures, educating residents about how to calculate and document smoking pack years, counsel patients on the importance of lung cancer screening, and order lung cancer screening using the EPIC order set. Results: Prior to any interventions, CHRISTUS Good Shepherd Internal Medicine Resident Clinic lung cancer screening metric was at 42% during the 3rd quarter of 2022. In-class lectures started during the 4th quarter of 2022. At the 4th quarter of 2022 and the 1st quarter of 2023, lung cancer screening rates increased to 44% and 52%, respectively. It was noticed that the metric plateau was about 48% over the next two quarters resulting in an overall increase of 5% from the pre-intervention phase. Conclusions: Our project showed that educating residents on the lung cancer screening guidelines and its application in clinical practice led to an increased rate of lung cancer screenings. The plateau in our study highlights the need for ongoing medical education and additional interventions to achieve substantial improvements in screening rates. Perhaps, targeting education toward patients about the importance, affordability, and safety of lung cancer screening could complement resident education and create a synergistic effect. We aim to further investigate how patient-centered interventions, like providing educational flyers in clinics and public places, can influence lung cancer screening rates.