With the aid of a $3.5 million National Institutes of Health grant (R01HL158850), investigators from Rutgers Cancer Institute of New Jersey – the state’s only National Cancer Institute-designated Comprehensive Cancer Center – along with Holden Cancer Center at the University of Iowa, and the University of Texas MD Anderson Cancer Center, are collaborating on a project to address lung cancer screening disparities among individuals with a history of heavy smoking. The researchers will assess the effectiveness of a decision support intervention called TELESCOPE (TELEhealth Shared decision-making COaching and navigation for lung cancer screening in Primary care)) that will be the focus of a randomized clinical trial to be opened at 40 primary care practices within the Combined Medical Group of RWJBarnabas Health and in collaboration with Rutgers Cancer Institute.
According to the American Cancer Society, lung cancer continues to be the leading cause of cancer deaths despite the fact that survival rates have been improving over the past decade. Early detection of lung cancer through low-dose CT scans has proven to be an effective way to reduce mortality and improve outcomes, however, not all individuals have access to quality cancer screenings which creates significant disparities in cancer outcomes. Additionally, some primary care clinicians face challenges in adequately discussing cancer screening with patients. These challenges include lack of time, competing clinical demands, being unaware of guidelines and clinical trial results, and limited training in shared decision making.
The study is led by principal investigators Anita Kinney, PhD, director of the Cancer Health Equity Center of Excellence at Rutgers Cancer Institute and Rutgers School of Public Health along with Richard M. Hoffman, MD, MPH, professor of internal medicine at University of Iowa Carver College of Medicine and Robert J. Volk, PhD, professor in the Department of Health Services Research at MD Anderson Cancer Center. Through the TELESCOPE intervention, the team will evaluate whether telemedicine decision coaching and patient navigation compared to enhanced usual care will increase initial screening uptake, improve quality of lung cancer screening decision making and increase referrals for smoking cessation. The intervention will be tested in 420 patients.
“There is currently much uncertainty about how to most effectively engage patients in shared decision making for lung cancer screening,” notes Dr. Kinney, who is also associate director for Population Science and Community Outreach at Rutgers Cancer Institute and professor of biostatistics and epidemiology at Rutgers School of Public Health. “This project has the potential to reduce health disparities and greatly advance the field of cancer control by developing and evaluating a novel and highly scalable care delivery model by providing patients with high-quality decision support about and access to lung cancer screening.”
Investigators also will examine whether use of the TELESCOPE intervention will promote adherence to subsequent diagnostic testing and annual lung cancer screenings. “By providing an effective intervention that can be implemented readily in real-world primary care settings, we can help provide shared decision making strategies for busy clinicians to support lung cancer screening in racially and ethnically diverse populations. It is also an opportunity to provide data for policy makers and payers to support a new model to increase guideline-concordant lung cancer screening,” adds Kinney, who is also director of ScreenNJ, a statewide cancer education and screening program.
The project period runs for five years.
[Source(s): Rutgers Cancer Institute of New Jersey, Newswise]