Symposium highlights results of breakthrough cancer screening trials

Symposium highlights results of breakthrough cancer screening trials


Low-dose CT scans are dramatically more effective than chest X-rays in detecting early stages of lung cancer, and Delaware is primed to use those findings to affect lung cancer mortality and find early-stage lung cancers to save lives. Those were key messages delivered to attendees of the Helen F. Graham Cancer Center & Research Institute’s 2014 Cancer Symposium held at the John H. Ammon Medical Education Center, Oct. 2.

Gerald O’Brien, M.D., medical director, Interventional Pulmonary Medicine and director of Pulmonary Hypertension at Christiana Care Pulmonary Associates, presented supporting data from the National Lung Screening Trial, a study sponsored by the National Cancer Institute to evaluate the effectiveness of low-dose computed tomography (CT) scans versus standard chest X-rays in screening for lung cancer, the number one cancer killer of both men and women in the United States and cause of 160,000 deaths each year. Dr. O’Brien said he was impressed by the trial’s conclusions.

Low-dose CT scans produced a 20 percent reduction in lung cancer mortality and detected lung cancer better than chest X-rays more than twofold. They found the cancers early and prevented development of late-stage cancer.

As a result, lung cancer screening has already been endorsed by the American Lung Association, American Association of Thoracic Surgeons, American College of Chest Physicians, American Society of Clinical Oncology, American Thoracic Society, American Cancer Society, U.S. Preventive Services Task Force and National Comprehensive Cancer Center Network. The latter has already detailed what it considers the essential elements needed to create a comprehensive screening program using CT scans: sophisticated, multi-detector CT scanners and analytic software, qualified radiologists, appropriate guidelines on how to report and manage abnormalities, a reliable communication system to convey the information to all involved in the care of the patient, and multidisciplinary teams to manage care and document outcomes. All of these elements are already being assembled at Christiana Care and elsewhere in the First State, thanks to the continued leadership of the Delaware Cancer Consortium’s Early Detection and Prevention Committee.

“The consortium has been leading the way for more than 10 years now,” said Stephen Grubbs, M.D., medical oncologist, Department of Medicine, Christiana Care Health System and clinical assistant professor of medicine at Sidney Kimmel Medical College. “It is widely recognized as one of the most effective cancer control programs in all 50 states.

In 2013, in fact, the American Association of Clinical Oncology and the American Society of Cancer Research listed Delaware’s accomplishments in colorectal cancer screening as one of top cancer new outcomes in the world.” Screening for Life, the consortium’s state and federally funded program, will serve the underinsured and uninsured and use strict screening eligibility guidelines, a reporting structure for physicians, contracts for approved radiology sites, and a nurse navigator to guide patients and physicians through the program. Using $1.5 million allocated in the state’s current fiscal budget, Screening for Life will cover the CT scans and interpretation of their results by radiologists and multi-disciplinary teams and then transition patients found to have lung cancer to the Delaware Cancer Treatment Program to cover the costs of treatment.

Clockwise from top left: Heather Bittner Fagan, M.D., MPH, FAAFP; David M. Bercaw, M.D., FAAFP; Gerald O’Brien, M.D.; and Stephen Grubbs, M.D.
Clockwise from top left: Heather Bittner Fagan, M.D., MPH, FAAFP; David M. Bercaw, M.D., FAAFP; Gerald O’Brien, M.D.; and Stephen Grubbs, M.D.

The panel discussion that concluded the symposium emphasized the value of a team approach to screening and fighting this disease. As William Bowser, Esq., chairperson of the Delaware Cancer Consortium said, “There are survivor walks for nearly every cancer, but not lung cancer. There are no walks because there are no survivors.”

Bowser was joined on the panel by Drs. O’Brien and Grubbs and colleagues representing primary care physicians, radiologists and private insurance companies, all of whom, the panel agreed, stand ready to support the new screening process throughout Delaware.

Dr. Grubbs said the Screening for Life program hopes to welcome its first patients in December. Christiana Care’s Lung Health and Screening Program began in September.