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The press release below was prepared by University of Utah Health. View the original.
Lung cancer kills more people than any other cancer in the U.S. However, a highly effective lung cancer screening could prevent up to a fifth of those deaths.
Researchers at the University of Utah (the U) have designed new digital tools that prompt doctors to consider lung cancer screening for high-risk patients and provide personalized guidance on screening. Since their implementation, the digital tools have sparked doctor-patient conversations and quadrupled the amount of lung cancer screens for high-risk patients.
Until recently, lung cancer was often caught too late to effectively treat. But recent improvements in screening and treatment have made a lifesaving difference. Wallace Akerley, MD, director of the Lung Cancer Disease Center at Huntsman Cancer Institute and professor of oncology at the U, adds that “while quitting or preventing tobacco use altogether is our highest goal, earlier diagnosis due to screening is equally important.”
“There is a tremendous need to enhance the support we give our providers and patients. These are the kinds of approaches we think can make that happen.”
For people at high risk of lung cancer, performing a CT scan of the chest for early signs of cancer can reduce the risk of dying from lung cancer by as much as 20%. Kensaku Kawamoto, MD, PhD, researcher at Huntsman Cancer Institute and professor of biomedical informatics at the U, calls the scan, “one of the most effective screening tools out there.”
Despite this, “screening rates historically have been abysmal,” Kawamoto continues. In 2020, only about 7% of eligible patients were screened for lung cancer nationwide.
The low rate of lung cancer screening may be because the risks and benefits of lung cancer screening vary between individual patients. The initial CT screen has a high rate of false positives—incorrectly indicating that a healthy patient has a concerning spot. This means that, for people at low risk of lung cancer, the potentially unnecessary follow-up procedures that accompany a positive result can cause more harm than good, explains Angie Fagerlin, PhD, chair of the Department of Population Health Sciences at Huntsman Cancer Institute.
To Screen or Not to Screen
Fagerlin wanted to find a way to make this complicated cost-benefit analysis easier. Then at the University of Michigan, she worked with collaborator Tanner Caverly, MD, to develop a web-based tool to guide patients and doctors through a discussion about whether to screen.
The tool uses each patient’s demographic information and history of smoking to estimate their personalized risk of lung cancer. It also includes questions designed to assess the patient’s levels of concern about lung cancer and false positives, bringing their own priorities into the conversation. “People’s goals, their values, their preferences, the way they think about health care, really influence whether or not they get screened,” Fagerlin says.
Kawamoto led a team of researchers that took the tool a step further by building an app that makes the discussion about lung cancer screening more efficient and streamlined. The app, Decision Precision+, automatically integrates data from a patient’s health records into their personalized risk assessment and helps clinicians incorporate shared decision making into busy clinical workflows.
Since these digital tools went into use at the U, screenings for eligible patients have increased by 400%.
New Technologies Help Personalize Care
The lung cancer screening tool isn’t the only way the researchers are using informatics to support evidence-based treatment. The app is part of a broader initiative led by Kawamoto and Guilherme Del Fiol, MD, PhD, a researcher at Huntsman Cancer Institute and professor of bioinformatics at the U. The initiative, called ReImagine EHR, seeks to improve health care by making software that automatically integrates patients’ health records to help doctors provide personalized care.
“While quitting or preventing tobacco use altogether is our highest goal, earlier diagnosis due to screening is equally important.”
So far, the initiative has sparked a suite of more than ten digital health tools, from a tool that uses patient health records and chatbots to facilitate genetic testing for patients at risk for hereditary cancers to a tool that helps doctors provide better care for babies with newborn jaundice, which can lead to brain damage if not caught and treated early. Most of these tools are currently in use at the U, helping doctors provide evidence-based care to every patient, every time.
“There is a tremendous need to enhance the support we give our providers and patients,” Kawamoto adds. “We want to make it so we can very systematically provide, in an efficient way, the best-known care to every patient. These are the kinds of approaches we think can make that happen.”
Media Contact
Heather Simonsen
Public Relations
Huntsman Cancer Institute
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About Huntsman Cancer Institute at the University of Utah
Huntsman Cancer Institute at the University of Utah is the National Cancer Institute-designated Comprehensive Cancer Center for Utah, Idaho, Montana, Nevada, and Wyoming. With a legacy of innovative cancer research, groundbreaking discoveries, and world-class patient care, we are transforming the way cancer is understood, prevented, diagnosed, treated, and survived. Huntsman Cancer Institute focuses on delivering the highest standard of care and the most advanced treatments, ensuring world-class cancer care is available to all communities in the area we serve. We have more than 300 open clinical trials and 250 research teams studying cancer at any given time. More genes for inherited cancers have been discovered at Huntsman Cancer Institute than at any other cancer center. Our scientists are world-renowned for understanding how cancer begins and using that knowledge to develop innovative approaches to treat each patient’s unique disease. Huntsman Cancer Institute was founded by Jon M. and Karen Huntsman.