Community Support Program for Lung Cancer Screening

(LCS II Trial)

Overseen By Caroline Rosen

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Abramson Cancer Center at Penn Medicine

Disqualifiers: Lives outside Philadelphia

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

100 Participants Needed

Trial Summary

What is the purpose of this trial?

This is a West Philadelphia based community project to improve adherence to lung cancer screening. The overall objective of this project is to demonstrate the impact of a community support program (CSP) on improve adherence to LCS follow-up guidelines in an urban environment. The study will target individuals in the Penn Medicine healthcare system residing in Philadelphia with an upcoming or missed follow-up screening or orders placed but who have not yet scheduled their screenings by offering free transportation coordination to and from the appointment. The study team will also offer to connect those with placed but unscheduled low dose CT orders to connect with Penn Medicine's scheduling staff.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Scheduling, Transportation in the Community Support Program for Lung Cancer Screening?

Research shows that patient navigation, which includes scheduling and transportation support, improves lung cancer screening rates among underserved populations. This suggests that similar support services can help increase access to lung cancer screening, potentially improving early detection and survival rates. ^{1 2 3 4 5}

Is the Community Support Program for Lung Cancer Screening safe for humans?

The research articles provided do not contain specific safety data for the Community Support Program for Lung Cancer Screening or related interventions like Scheduling and Transportation. They focus on the effectiveness and barriers of lung cancer screening programs, but do not address safety concerns. ^{4 6 7 8 9}

How does the Community Support Program for Lung Cancer Screening differ from other treatments?

The Community Support Program for Lung Cancer Screening is unique because it uses a Community Health Worker (CHW) model to increase lung cancer screening rates, particularly among underserved groups like Chinese immigrant drivers. This approach is culturally tailored and focuses on education and support, which is different from traditional medical treatments that focus solely on medical procedures or medications. ^{2 10 11 12 13}

Research Team

Farouk Dako, MD

Principal Investigator

[e-mail]

Eligibility Criteria

This trial is for individuals in Philadelphia who are due or have missed their low dose CT scan for lung cancer screening. Participants must be part of the Penn Medicine healthcare system and will receive help with transport and scheduling.

Inclusion Criteria

I am due for or missed my low dose CT scan for lung cancer.

I live in Philadelphia.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Community Support Program Implementation

Participants receive support through transportation coordination and scheduling assistance to improve adherence to lung cancer screening follow-up

6 months

Follow-up

Participants are monitored for adherence to lung cancer screening follow-up guidelines

6 months

Treatment Details

Interventions

• Scheduling
• Transportation

Trial Overview The study tests a community support program (CSP) that provides free transportation and helps schedule screenings to see if it improves adherence to follow-up guidelines for lung cancer screening in an urban setting.

Participant Groups

Group I: West Philadelphia Experimental Treatment 2 Interventions

Eligible patient population lives in West Philadelphia

Group II: Southwest Philadelphia Active Control 1 Intervention

Eligible patient population lives in Southwest Philadelphia

Who Is Running the Clinical Trial?

Abramson Cancer Center at Penn Medicine

Lead Sponsor

Trials

425

Recruited

464,000+

University of Pennsylvania

Collaborator

Trials

2,118

Recruited

45,270,000+

Findings from Research

In New York state, nearly half (48.3%) of lung cancer patients were diagnosed with late-stage disease, highlighting the need for improved access to lung cancer screening resources, especially in rural areas.

The study found that rural counties had fewer lung cancer screening centers and higher lung cancer mortality rates, indicating that geographic disparities in healthcare resources significantly impact patient outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Multilevel Approach to Investigate Relationships Between Healthcare Resources and Lung Cancer. Somayaji, D., Seo, YS., Wilding, GE., et al.[2023]

In British Columbia, the median travel time to lung cancer screening sites was 11.7 minutes, but this increased significantly for patients in rural areas, with 99% of those facing over 60 minutes of travel living in these regions.

The study found that longer drive times to screening sites were linked to various factors such as sex, economic status, and situational vulnerability, indicating that disadvantaged groups may need additional support to access lung cancer screening services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Addressing Inequity in Spatial Access to Lung Cancer Screening. Simkin, J., Khoo, E., Darvishian, M., et al.[2023]

Lung cancer screening has been shown to improve survival rates, but many people are not participating in these screenings due to various barriers.

The authors emphasize the importance of creating a tailored and adaptable lung cancer screening program that addresses community needs, involves key stakeholders, and optimizes health systems for better patient follow-up.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Building a Lung Cancer Screening Program. Chudgar, NP., Stiles, BM.[2023]

A community-based lung cancer CT screening program significantly improved 5-year survival rates to 64% compared to only 19% in nonscreened patients, demonstrating the effectiveness of early detection in improving outcomes.

The program identified lung cancer at earlier stages (I or II) in 75% of cases, indicating that CT screening can benefit even those who do not meet the high-risk criteria established by the National Lung Screening Trial.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Community-Based Multidisciplinary Computed Tomography Screening Program Improves Lung Cancer Survival. Miller, DL., Mayfield, WR., Luu, TD., et al.[2022]

A patient navigation program significantly increased lung cancer screening rates among high-risk smokers, with 31% of those in the intervention group receiving chest CTs compared to only 17.3% in the control group.

The program also led to a higher percentage of eligible participants undergoing lung cancer screening (92% in the intervention group), resulting in a diagnosis of lung cancer in 2% of screened patients, highlighting its efficacy in early detection.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patient navigation for lung cancer screening among current smokers in community health centers a randomized controlled trial. Percac-Lima, S., Ashburner, JM., Rigotti, NA., et al.[2019]

Transportation insecurity is a significant issue for cancer patients in the U.S., leading to missed or altered care that can increase cancer recurrence and mortality rates.

Efforts are underway to develop protocols and policies to identify and support at-risk patients, recognizing transportation as a critical factor influencing cancer care outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Addressing Transportation Insecurity Among Patients With Cancer. Graboyes, EM., Chaiyachati, KH., Sisto Gall, J., et al.[2023]

Mass screening for lung cancer in high-risk populations has the potential to significantly improve early detection and increase the odds of surgical cure, as highlighted by the National Lung Screening Trial and recent European studies.

The review discusses strategies to maximize the benefits of lung cancer screening while minimizing potential harms, emphasizing the importance of implementing effective public health programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Update on screening for lung cancer. Arenberg, D.[2023]

Low-dose computed tomography scanning can reduce lung cancer-specific mortality by 20% in high-risk individuals, but participation in lung cancer screening (LCS) remains low among these groups.

Factors such as lack of health insurance, absence of a primary healthcare provider, and being part of certain racial/ethnic minorities significantly decrease the likelihood of participating in LCS, highlighting the need for targeted interventions to improve screening uptake.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Understanding Factors Associated with Uptake of Lung Cancer Screening among Individuals at High Risk. Gudina, AT., Kamen, C., Cheruvu, VK., et al.[2023]

A randomized controlled trial involving 225 patients showed that telephone-based navigation significantly helped identify and address barriers to lung cancer screening, with personal and provider-related issues being the most common.

Provider-related barriers decreased by 80% during the screening process, indicating that patient navigation can effectively improve access to lung cancer screening, especially among minority and underserved populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessing Barriers and Facilitators to Lung Cancer Screening: Initial Findings from a Patient Navigation Intervention. Lee, SJC., Lee, J., Zhu, H., et al.[2023]

Chinese immigrant livery drivers with a smoking history are at high risk for lung cancer and showed uncertainty about the link between smoking and cancer, as well as unfamiliarity with lung cancer screening (LCS).

A culturally adapted community health worker (CHW) program is viewed as an acceptable and feasible way to increase LCS uptake among this group, highlighting the need for tailored interventions to improve access to early detection and preventive care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Chinese Livery Drivers' Perspectives on Adapting a Community Health Worker Intervention to Facilitate Lung Cancer Screening. Leng, J., Lui, F., Gany, F.[2023]

Chinese immigrant for-hire vehicle drivers are at a high risk for lung cancer due to smoking and air pollution, yet they often do not participate in lung cancer screening (LCS).

A community needs assessment identified key themes for adapting a Community Health Worker (CHW) program, emphasizing the need for culturally tailored health education to improve LCS knowledge and accessibility among this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Healthcare Professionals' Perspectives on Adapting a Community Health Worker Model to Facilitate Lung Cancer Screening for Chinese For-Hire Vehicle Drivers. Leng, J., Li, R., Lui, F., et al.[2023]

The Lung AIR intervention effectively increased knowledge and reduced fear about lung cancer screening among 292 participants, demonstrating its feasibility as a community-based educational program.

One-on-one phone sessions were particularly effective, leading to greater increases in participants' intention to complete screening compared to in-person group sessions, especially among those with lower income and higher smoking rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adapting Community Educational Programs During the COVID-19 Pandemic: Comparing the Feasibility and Efficacy of a Lung Cancer Screening Educational Intervention by Mode of Delivery. Bouchard, EG., Saad-Harfouche, FG., Clark, N., et al.[2023]

A systematic review of 32 studies on lung cancer screening (LCS) found that targeted interventions, like smoking cessation programs, can positively influence psychosocial outcomes, such as increasing motivation to quit smoking.

However, the overall impact of service delivery components on psychological outcomes was inconsistent, highlighting the need for more high-quality, real-world studies to better understand how to optimize LCS programs for improved psychosocial well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Lung cancer screening program factors that influence psychosocial outcomes: A systematic review. McFadden, K., Rankin, NM., Nickel, B., et al.[2023]

References

1. United States pubmed.ncbi.nlm.nih.gov

A Multilevel Approach to Investigate Relationships Between Healthcare Resources and Lung Cancer. [2023]

2. Switzerland pubmed.ncbi.nlm.nih.gov

Addressing Inequity in Spatial Access to Lung Cancer Screening. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Building a Lung Cancer Screening Program. [2023]

4. Netherlands pubmed.ncbi.nlm.nih.gov

Community-Based Multidisciplinary Computed Tomography Screening Program Improves Lung Cancer Survival. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Patient navigation for lung cancer screening among current smokers in community health centers a randomized controlled trial. [2019]

6. United States pubmed.ncbi.nlm.nih.gov

Addressing Transportation Insecurity Among Patients With Cancer. [2023]

7. China pubmed.ncbi.nlm.nih.gov

Update on screening for lung cancer. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Understanding Factors Associated with Uptake of Lung Cancer Screening among Individuals at High Risk. [2023]

9. United States pubmed.ncbi.nlm.nih.gov

Assessing Barriers and Facilitators to Lung Cancer Screening: Initial Findings from a Patient Navigation Intervention. [2023]

10. United States pubmed.ncbi.nlm.nih.gov

Chinese Livery Drivers' Perspectives on Adapting a Community Health Worker Intervention to Facilitate Lung Cancer Screening. [2023]

11. England pubmed.ncbi.nlm.nih.gov

Healthcare Professionals' Perspectives on Adapting a Community Health Worker Model to Facilitate Lung Cancer Screening for Chinese For-Hire Vehicle Drivers. [2023]

12. England pubmed.ncbi.nlm.nih.gov

Adapting Community Educational Programs During the COVID-19 Pandemic: Comparing the Feasibility and Efficacy of a Lung Cancer Screening Educational Intervention by Mode of Delivery. [2023]

13. England pubmed.ncbi.nlm.nih.gov

Lung cancer screening program factors that influence psychosocial outcomes: A systematic review. [2023]