There is a gap in our knowledge of how the results of the National Lung Screening Trial (NLST) will impact the use of low dose computed tomography (LDCT) for lung cancer screening in the general population. Given the high incidence and mortality rates of lung cancer, developing evidence on the utility of a screening test that can reduce lung cancer mortality will likely lead to a significant improvement in public health. The long-term goal is to examine the delivery and quality of lung cancer screening across the U.S. by creating a prospective population based registry that captures patient, radiologist, and outcome information on the use of LDCT for screening. The objective of this application is to pilot test a population based lung cancer screening registry and determine the extent to which lung cancer screening with LDCT has diffused across the state. We plan to accomplish these objectives by pursuing the following two specific aims: (1) Develop and implement the tools required to establish a population-based lung cancer screening registry;and (2) Examine the availability of lung cancer screening with LDCT among radiology practices in the state. The study will focus on developing and implementing data collection elements as well as constructing a secure data entry system for capturing screening information from patients and radiologists. By conducting a survey of CT accredited radiology facilities we will investigate the characteristics o facilities currently performing screening in the state and also identify facilities for partnershipin the subsequent expansion phase. Currently, recommendations for LDCT for lung cancer screening are mixed, yet there is a growing need to monitor the screening experience as academic centers and community practices begin to adopt this technology for early detection in high-risk groups. This is an innovative pilot study that uses established methods in population based registry development and survey methodology to explore an emerging clinically relevant cancer screening area which is widely debated. The proposed research is significant because it will provide preliminary data on the use of LDCT for lung cancer screening in the non-clinical trial population and will also create a system for ongoing data capture that will inform the delivery and quality of lung cancer screening as this technology diffuses into the community.
The proposed research is relevant to public health because it will be the initial step in generating timely and relevant population based data on the use of LDCT for lung cancer detection among the 94 million current and former smokers at increased risk of developing lung cancer. The formation of a registry will enable the collection of data that will assist in answering questions beyond those of the prior trials;hence, the proposed research is relevant to the part of NCI's mission that pertains to supporting research projects in cancer control that will help inform guideline development and policy decisions.