Promoting Equitable Access to Lung Cancer Screening

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By: Jaimie Roebuck, Communications Advisor, Women's College Hospital

Lung cancer is the leading cause of cancer death in Canada, responsible for a quarter of all cancer-related deaths in the country. Fifty per cent of all lung cancer cases are detected at an advance stage, which can lead to a poorer prognosis and worsened health outcomes. When diagnosed at stage four, the likelihood of surviving lung cancer at least five years after diagnosis is roughly 19 per cent in Canada.

Conducting a CT scan can allow us to screen for lung cancer and find the disease when it is still small and curable. When cancer is caught in the earlier stages, it requires less invasive treatment and the rate of survival is higher. However, those at greatest risk of lung cancer, and therefore, the target of lung cancer screening interventions, are also the least likely to participate in lung cancer screening.

The unequal uptake of lung cancer screening interventions perpetuates preventable health gaps. To address this issue, we must reallocate resources to meet the needs and priorities of those experiencing the most inequities. This method, known as a 'priority population' approach, considers structural inequalities that heighten the risk of disease and impede access to care. Clinical encounters within our healthcare system that are equity-oriented and trauma- and violence-informed can play a role in a patient's decision to pursue lung cancer screening. Conversely, experiences that are rooted in stigma or bias can have the opposite effect and may deter a patient from participating in a screening program.

Dr. Ambreen Sayani (pictured left), patient-oriented researcher at Women's College Hospital, and her team of co-collaborators, recently published a paper in BMC outlining their study to promote equitable access to lung cancer screening.

This patient-partnered study involves multiple stakeholders coming together, including patients, healthcare providers and policy makers, to improve equity in access to lung cancer screening. The team will create an online learning module to educate healthcare providers on how life experiences shape smoking behaviour and lung cancer risk. The module will also share key skills on how to deliver care that's timely, appropriate and safe. Once the module is complete, it will be freely available to all healthcare providers to support the fair and just delivery of lung cancer screening in Ontario and beyond.

By taking steps to involve and engage patients in research, we can promote the design and delivery of healthcare services that are accessible and acceptable to patients. This is particularly important for lung cancer screening, as those at highest risk of developing lung cancer are also least likely to get screened. By encouraging screening among high-risk patients, we can accelerate the detection of early-stage, treatable lung cancers and reduce mortality associated with the disease.

This CIHR-funded Strategy for Patient Orientated Research (SPOR) study is an important step forward towards enhancing the delivery of equitable primary care and access to lung cancer screening for priority populations.