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BJC Collaborative study promoting lung cancer screening begins in Illinois and Missouri

A new BJC Collaborative (BJCC) joint research endeavor with Washington University School of Medicine aims to educate patients and physicians about low-dose CT lung cancer screening so they can take advantage of this potentially life-saving new technology.

Lung cancer is the leading cause of cancer deaths in the U.S., accounting for 25 percent of cancer deaths annually. The new study, I-STEP (which stands for Increasing Screening Through Engaging Primary Care Providers), intends to address this problem by assisting primary care providers in setting up a simple, low-cost, office-based system for referrals for low-dose CT (LDCT) lung cancer screening. This BJCC study is being administered by WUSM’s Division of Public Health Sciences.

LDCT has the ability to detect lung cancer at its earliest stages, when it’s most treatable. The test uses about a quarter of the radiation that a normal CT scan does. When performed annually on eligible current or former smokers, LDCT is proven to reduce the risk of lung cancer death by up to 20 percent, when compared to screening by chest X-ray.

Lung cancer screening is recommended by the U.S. Preventive Services Task Force, and reimbursement is in place through Medicare. “Now, five years after the recommendation for screening, rates remain exceedingly low,” says Graham Colditz, MD, a principal investigator of the I-STEP trial and associate director of prevention and control at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine.

Similar to how eligibility guidelines for mammography screening were implemented years ago, the I-STEP trial seeks to increase screening rates with the use of a “toolkit” that contains materials to help primary care providers identify and educate patients who are eligible for screening.

The toolkit also provides information and local resources to help patients quit smoking. According to Dr. Colditz, “The intervention toolkit will help primary care providers make identification and referral of eligible patients a part of routine care.”

The overall goal of I-STEP is to increase the number of eligible patients being screened and to gain a better understanding of how screening guidelines can be implemented in a clinical setting to most effectively reach at-risk patients and improve population health.

Aimee James, PhD, the co-principal investigator for I-STEP and co-program leader for prevention and control at Siteman Cancer Center, adds, “For us to truly achieve the full benefit of lung cancer screening, we need to get the message out to patients who are at higher risk of lung cancer and show the benefits of screening. Reaching people in primary care — while they’re healthy — and giving patients and primary care providers the tools to have meaningful discussions about screening is important.”

Six of the eight health systems affiliated with BJCC are participating in I-STEP. Decatur Memorial Hospital (Decatur, Illinois) was the first to begin implementation of the trial April 22. Memorial Health System (Springfield, Illinois), Southern Illinois Healthcare (Carbondale, Illinois), CoxHealth (Springfield, Missouri), Barnes-Jewish St. Peters Hospital and Sarah Bush Lincoln Health System (Mattoon, Illinois) will join at three-month intervals over the next year and a half.

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