Kentucky Clinicians and Researchers Work to Improve Lung Cancer Screening and Detection Rates
In the heart of Kentucky, a group of dedicated clinicians and researchers are working tirelessly to improve outcomes for lung cancer patients and their families. Led by the Kentucky LEADS (Lung Cancer Education, Awareness, Detection, and Survivorship) Collaborative, these individuals are focused on increasing screening rates and catching tumors earlier, when they are more treatable.
The motivation behind their work stems from personal experiences, such as that of Anthony Stumbo, an internal medicine physician. Stumbo’s mother was diagnosed with inoperable lung cancer in 1997, and he vividly remembers the devastating impact it had on his family. Determined to prevent other families from experiencing the same pain, Stumbo joined the collaborative to promote training and raise awareness about early detection.
Their efforts have not been in vain. Kentucky now screens more high-risk residents for lung cancer than any other state except Massachusetts. In 2022, 10.6% of eligible residents were screened, more than double the national rate of 4.5%. This achievement is a result of a decade-long push by Kentucky researchers to promote lung cancer screening, following the recommendation of the U.S. Preventive Services Task Force in 2013.
The collaborative has worked closely with clinicians and hospital administrators across the state to boost screening rates, even in rural areas like Appalachia. However, they face a significant challenge in overcoming the fear and stigma associated with smoking and lung cancer. Kentucky has one of the highest lung cancer death rates in the country, along with neighboring states like Tennessee and West Virginia.
Lung cancer is the leading cause of cancer-related deaths in the United States, particularly in states like Kentucky. The death rates are highest in regions where smoking rates are historically high. However, the collaborative’s efforts are already showing promising results. More cancers in Kentucky are being detected at an earlier stage, making them easier to treat. The percentage of advanced cases has decreased from 81% between 2000 and 2014 to 72% in 2020.
Jennifer Knight, a LEADS principal investigator, expressed optimism about the impact they are making. “We are changing the story of families. And there is hope where there has not been hope before,” she said. The collaborative works with various partners, including the University of Kentucky, the University of Louisville, and GO2 for Lung Cancer. They have provided training and support to 10 hospital-based screening programs, with the aim of improving outcomes for lung cancer patients across the state.
The success of the Kentucky LEADS program has caught the attention of experts in the field. Jacob Sands, a lung cancer physician at Boston’s Dana-Farber Cancer Institute, praised their efforts, stating that they are “moving the needle in implementing lung screening on a larger scale.” Sands emphasized the importance of annual screening and follow-up testing for suspicious nodules, which the Kentucky program encourages.
One of the key factors contributing to increased screening rates in Kentucky is the expansion of Medicaid in 2014. This allowed more lower-income individuals to qualify for lung cancer screening and related treatment. Adults between the ages of 50 and 80 with a smoking history are advised to get a CT scan every year if they have accumulated at least 20 pack years (calculated by multiplying the packs of cigarettes smoked daily by years of smoking).
Regular screening has been proven to significantly improve survival rates for lung cancer patients. When lung cancer is detected early through a CT scan, patients have an 81% chance of living at least 20 years. This data highlights the importance of early detection and the potential impact it can have on patients’ lives.
Despite the progress made in Kentucky, there is still work to be done. Screening rates vary widely across the country, with Massachusetts leading the way at 11.9% and California lagging behind at just 0.7%. Efforts to increase screening rates in California have been hindered by the stigma associated with smoking, as well as the reluctance of eligible patients to disclose their smoking history to healthcare providers.
In Kentucky, the collaborative continues to make strides in improving lung cancer screening and detection rates. At Appalachian Regional Healthcare, the number of patients screened has increased significantly in recent years, from 372 in 2017 to 3,071 in 2023. However, they believe they have only scratched the surface of their potential impact.
For Anthony Stumbo, the fight against lung cancer is personal. He carries the grief of losing his mother at a young age and not being able to share important moments with her. Through his work with the collaborative, he hopes to prevent other families from experiencing the same pain and loss. “Knowing that my children were born, and never knowing their grandmother,” he said, “just how sad is that?”
The efforts of the Kentucky LEADS Collaborative serve as a beacon of hope for lung cancer patients and their families. By increasing screening rates and
