By Melissa Patrick
Kentucky Health News
The Appalachian Community Cancer Alliance has launched a lung cancer screening initiative to improve cancer screenings in rural Appalachia and Pike County is part of its initial pilot project.
Dr. Michael Gieske, the director of lung cancer screening at St. Elizabeth Healthcare, told Kentucky Health News that he had been working with the alliance off and on for about four an a half years, most recently on projects that involve diversity, equity and inclusion, which he said naturally extends to the Appalachian region, which includes 13 states.
Gieske added that the alliance is recognized by President Biden's Cancer Moonshot Initiative and has been charged with improving cervical, colon and lung cancer screenings in the Appalachian region.
"And they felt after some of their initial work that lung cancer screening was by far the greatest need and demonstrated the greatest disparities when you were looking at health care inequities," he said.
This realization prompted the alliance to form the Rural Appalachian Lung Cancer Screening Initiative, a multidisciplinary group of which Gieske is the subject matter expert.
Gieske said St. Elizabeth Healthcare, which has one of the most robust lung cancer screening programs in the country, has done 33,000 lung cancer screenings since 2013 and has found 525 lung cancers overall. Of those, he said 59% of the lung cancers that they have found have been Stage I and 70% of them are in either Stage I or Stage II, which are considered the early stages of lung cancer.
"We're finding it when the chance of cure can be greater than 90%," he said.
And, he said, because of the improvements in the treatment in lung cancer, it's really important to emphasize that even people with late stage lung cancers are surviving.
Pilot project
To decide on the location of the pilot project site, leaders of the initiative used geospatial mapping to find the intersection of the highest mortality rates and lowest access to care in Appalachia, Meg Barbor writes for the ASCO Post.
Upon looking at this map, Gieske said, "It was very apparent that there was a glaring area where Kentucky, West Virginia and Virginia came together., where they had the highest incidence of lung cancer, the highest mortality from lung cancer, the worst five years survival rates, the highest smoking rates, the worst access, the highest poverty rates, the lowest education rates, and all these came together in this region. So we thought, well, this is probably going to be a very difficult challenging area to work in, but at the same time, it would give us an opportunity for the greatest impact."
The pilot will include 10 counties that Gieske said "really lit up the brightest" on that map. He said Pike County is the only county from Kentucky and that they would be working with Dr. Aasems Jacob, a pulmonologist at Pikeville Medical Center, on the project.
He said five of the counties were in Virginia and four of them were in West Virginia.
Dr. Leigh Boehmer, chief medical officer and deputy executive director of ACCC, told Barbor that the initiative aims to increase lung cancer screening rates by identifying and addressing informational, literacy, and cultural barrier that inhibit rural Appalachian residents from seeking recommended, preventive cancer care.
“The Alliance was designed to provide a platform to share promising, evidence-based, translatable practices and solutions to improve access and quality of care for patients in this part of the country," he said.
Gieske said "education and communication" are key when it comes to reaching out to primary care providers who are on the front line of care."Most EMRs will flag a patient if they meet the criteria and then it's it's up to the provider to order the test," he said. "Lung cancer is just as important if not more important than breast cancer and colon cancer and cervical cancer screening. Lung cancer kills more patients or more individuals in our state, in our country than prostate, breast and colon cancer combined. Lung cancer kills three times more women than breast cancer and a lot of women don't realize that."
The only recommended screening for lung cancer is low-dose computed tomography, also called a low-dose CT scan, according to the Centers for Disease Control and Prevention. Annual CT scans are recommended for adults between 50 and 80 who have smoked at least 20 "pack-years" (a pack-year amounting to one pack of cigarettes a day for a year, or an equivalent amount, such as half a pack a day for two years) and either still smokes or has quit within the last 15 years. Medicare rules are a bit different.
Gieske added that Kentucky has along-history with lung cancer, largely because of tobacco related disease.
Gieske encouraged anyone who qualifies for lung cancer screening to get tested, noting that it is a simple test that takes about three minutes and does not require any "needles, tubes or dye."
"It's a very simple screening test with incredible results," he said.
from KENTUCKY HEALTH NEWS https://ift.tt/lWhFn7i
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