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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if a community support program can help individuals adhere to their lung cancer screening schedules. The program provides free transportation and scheduling assistance for those in the Penn Medicine system in Philadelphia with upcoming or missed low-dose CT scans. Residents of Philadelphia who need help making or keeping lung cancer screening appointments may be suitable candidates for this trial. As an unphased trial, this study offers a unique opportunity to contribute to research that could enhance access to lung cancer screenings for many.

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 prior data suggests that this community support program is safe for improving adherence to lung cancer screening?

Research shows that assistance with scheduling can make it easier for people to maintain regular lung cancer screenings. Studies have found that organizing appointments can lead to quicker treatment. One study demonstrated that having a guide to navigate the healthcare system improved screening attendance. This suggests that scheduling assistance is generally well-received and effective.

The study also examines providing transportation support. Although specific safety data is lacking, research indicates that transportation issues can prevent people from attending screenings. Offering transportation can help more people complete their screenings, suggesting it is a useful and safe way to improve healthcare access.

Both scheduling and transportation services are non-invasive and widely considered safe. They are designed to help people receive necessary screenings without introducing new risks. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores practical solutions like scheduling and transportation to improve lung cancer screening. Unlike traditional treatments that focus solely on medical interventions, this program aims to remove logistical barriers that prevent people from getting screened. By addressing these real-world challenges, the program hopes to increase early detection rates, which can lead to better outcomes for patients.

What evidence suggests that this community support program is effective for improving adherence to lung cancer screening?

This trial will compare the impact of community support programs in different areas. Studies have shown that helping people schedule their appointments can increase lung cancer screening rates. In the West Philadelphia arm of this trial, participants will receive scheduling assistance and guidance from a patient navigator, encouraging more high-risk individuals to get screened. Lung cancer screening is highly effective, saving one life for every 320 screenings.

Research indicates that providing transportation support can eliminate a major obstacle for up to one-third of cancer patients. By addressing transportation issues, more people can attend their appointments, aiding in early cancer detection. Overall, improving both scheduling and transportation can significantly increase the number of people getting screened and potentially save lives. ^{2 6 7 8 9}

Who Is on the Research Team?

Farouk Dako, MD

Principal Investigator

[e-mail]

Are You a Good Fit for This Trial?

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 live in Philadelphia.

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

Timeline for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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]

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]

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]

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]

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]

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 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]

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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12386249/

Effectiveness of Technology-Based Interventions in Promoting ... This study reviews how technology-based interventions have been designed and implemented to promote lung cancer screening (LCS), support shared decision-making, ...

2. sciencedirect.com sciencedirect.com/science/article/pii/S2347562525000940

Interventions targeted to improve lung cancer screening ... Combined intervention and patient navigation are most effective in increasing lung cancer screening uptake among high-risk individuals.

3. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2825517

Lung Cancer Screening at US Hospitals for People ... Lung cancer screening ranks as one of the most effective cancer screenings available, saving one person's life for every 320 screening computed tomography ...

4. asco.org asco.org/abstracts-presentations/ABSTRACT330863

Reducing delays to lung cancer treatment through ... Median time from diagnosis to treatment was 31 days, with 36% (N = 9) starting treatment in < 30 days. While appointment scheduling delays included both work-up ...

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9651125/

Development and testing of “Is Lung Cancer Screening for ... The goal of this study was to investigate the feasibility, acceptability, usability, and preliminary effectiveness of a computer-based decision aid.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7066861/

Patient navigation for lung cancer screening in an urban ... The National Lung Screening Trial demonstrated improved lung cancer mortality with annual low-dose computed tomography (CT) screening, leading to lung ...

7. sciencedirect.com sciencedirect.com/science/article/pii/S2589537024003225

Articles Benchmarking lung cancer screening programmes ... Ten-year results of the Multicentric Italian Lung Detection trial demonstrate the safety and efficacy of biennial lung cancer screening. Eur J Cancer, 118 ...

8. jamanetwork.com jamanetwork.com/journals/jamainternalmedicine/fullarticle/2819819

Patient Navigation for Lung Cancer Screening at a Health ... Study findings suggest that patient navigation may be an effective tool for promoting lung cancer screening engagement among people experiencing homelessness.

9. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8248958/

Successes and challenges of implementing a lung cancer ... In recent years, studies have shown that low-dose computed tomography (LDCT) is a safe and effective way to screen high-risk adults for lung cancer.