Mammography and Beyond: Enhancing Cancer Screening Programs

Mammography for breast cancer screening is a well-established routine practice among women in the United States, enjoying high participation rates.

Despite this, lung cancer screening (LCS) using low-dose CT scans remains significantly underutilized for both women and men. Only 4%-6% of LCS-eligible individuals undergo recommended screening annually, while approximately 72% of eligible women undergo screening mammography for breast cancer (Zambon et al.).

Meanwhile, lung cancer continues to be the leading cause of cancer death among women, highlighting a critical gap in early detection efforts. Recently, research has suggested a promising solution: pairing lung cancer screening with routine mammography to enhance lung cancer screening rates.

A study published on June 10 in the Journal of Surgical Research explores this innovative approach and its potential to improve cancer detection and outcomes that imaging facilities nationwide should take note of (Yue et al.).

Study Overview

The study, led by Tiffany Yue from Stanford University, aimed to assess the feasibility and acceptability of a dual cancer screening program combining breast and lung cancer screenings.

The researchers focused on understanding women's perceptions, knowledge, and attitudes toward lung cancer and its screening before and after participating in the dual screening program. They used qualitative surveys with women undergoing the combined screenings to gather insights into their experiences and opinions.

Participant Demographics

The study included women eligible for lung cancer screening with a median age of 57 years and a median of 36 pack years of smoking history. All participants were referred to thoracic surgery or pulmonary cancer screening clinics for shared decision-making visits.

Perceived Risk and Motivation

A significant finding from the study was that 98% of women felt they were at risk for lung cancer, with 80% motivated by the potential for early detection of cancer. This high perceived risk indicates a strong potential for encouraging women to participate in lung cancer screening programs.

Knowledge Gaps and Concerns

The study revealed substantial knowledge gaps and concerns among the participants. Specifically, 58% of women lacked knowledge about lung cancer screening eligibility, and 47% were concerned about the cost of screening. Addressing these barriers is crucial for increasing screening uptake.

Interest in Dual Screening

Before undergoing lung cancer screening, 87% of women expressed interest in the combined breast and lung cancer screening program. This high interest suggests that dual screening programs can effectively engage women already participating in routine mammography.

Post-Screening Sentiment

After participating in the dual screening program, 84% of women indicated they were likely or very likely to undergo dual screening again. Furthermore, 93% of participants found the shared decision-making visit helpful or very helpful. These positive responses highlight the acceptability and feasibility of dual-screening programs.

Feasibility and Acceptability

The study strongly supported the dual screening program from institutional stakeholders and screening participants. The program's feasibility, acceptability, adoption, and fidelity were evident from the high levels of interest and willingness among women to participate in lung cancer screening when paired with breast cancer screening. The findings suggest that such dual-screening programs can be successfully implemented and sustained in clinical practice.

Offering a Strategic Opportunity with Dual-Screening

By addressing knowledge gaps and cost concerns and leveraging the routine practice of mammography, imaging practices can significantly increase lung cancer screening uptake among eligible women. This dual-screening approach enhances the early detection of lung cancer and potentially reduces lung cancer mortality.

Implementing dual cancer screening programs for imaging practices represents a strategic opportunity to improve patient care and outcomes. By educating patients, fostering shared decision-making, and integrating screenings, practices can deliver higher-quality care. This study's findings underscore the importance of innovative approaches to cancer screening and provide a roadmap for practices to enhance their screening programs and ultimately save more lives.

References

1. Zambon, M., Regis, S., & Lamb, C. (2017). Comparison of Lung Cancer Screening Practices by Gender in a Large Single-Center Lung Screening Program. In Chest (Vol. 152, Issue 4, p. A623). Elsevier BV. https://doi.org/10.1016/j.chest.2017.08.656

2. Yue, T., Wong, L.-Y., Jani, C., Agarwal, L., Al Omari, O., Aghagoli, G., Ahmed, A., Bhatt, P., Lee, A., Lotz, M., Marmor, H., Paliotti, G., Pories, S., Richmond, J., Shula, L., Sandler, K. L., Conley Thomson, C., & Backhus, L. M. (2024). Combined Breast and Lung Cancer Screening Among Dual-Eligible Women: A Descriptive Study. In Journal of Surgical Research. Elsevier BV. https://doi.org/10.1016/j.jss.2024.05.024