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- Page navigation anchor for RE: Results of Lung Cancer Screening in the Community AND Lung Cancer Screening Guidelines Implementation in Primary Care: A Call to Action.RE: Results of Lung Cancer Screening in the Community AND Lung Cancer Screening Guidelines Implementation in Primary Care: A Call to Action.
Kudos to Handy et al. for their excellent report on their remarkable work.(1) They successfully marshaled the multidisciplinary resources of a large health system and created a rigorous, high-performing lung cancer screening (LCS) program. This included reviews by a multidisciplinary thoracic disease conference and deployment of a full-time LCS coordinator, who facilitated 99.9% follow-up of the 3,402 study participants.
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Their aim was to address the concern that outside of the rigorously-conducted NLST, LCS performed in typical community sites could fail to achieve similar outcomes. While they have demonstrated similar results in their system, they did so by committing significant resources and leveraging a well-designed program with high levels of engagement and follow-through. Unfortunately, the question remains: Are these results generalizable to typical community practice?
The authors also describe the “eager participation” of their primary care clinicians, leading one to wonder if perhaps it was too eager, promoting LCS without adequate shared decision-making (SDM). This has been demonstrated previously.(2,3)
Meanwhile, the “Call to Action” put forth in the same issue by Doubeni et al. concludes that “engagement of primary care clinicians and support from payers and funding agencies are needed to catalyze the adoption of LCS.”(4) In doing so, they seem to presume that the benefits of LCS uniformly exceed the harms. As the authors note, every o...Competing Interests: None declared.