Implementation of a New Screening Recommendation in Health Care: The Veterans Health Administration's Approach to Lung Cancer Screening
Authors: Linda S. Kinsinger, David Atkins, Dawn Provenzale, Charles Anderson, Robert Petzel
Journal: Annals of Internal Medicine (2014)

Ideas and Opinions21 October 2014Implementation of a New Screening Recommendation in Health Care: The Veterans Health Administration's Approach to Lung Cancer ScreeningLinda S. Kinsinger, MD, MPH, David Atkins, MD, MPH, Dawn Provenzale, MD, MS, Charles Anderson, MD, PhD, and Robert Petzel, MDLinda S. Kinsinger, MD, MPHFrom the Veterans Health Administration, Washington, DC., David Atkins, MD, MPHFrom the Veterans Health Administration, Washington, DC., Dawn Provenzale, MD, MSFrom the Veterans Health Administration, Washington, DC., Charles Anderson, MD, PhDFrom the Veterans Health Administration, Washington, DC., and Robert Petzel, MDFrom the Veterans Health Administration, Washington, DC.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M14-1070 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Last winter, the U.S. Preventive Services Task Force (USPSTF) gave a positive recommendation (B grade) for lung cancer screening with low-dose computed tomography. The recommendation applies to high-risk adults aged 55 to 80 years with a smoking history of at least 30 pack-years who are still smoking or have quit within the past 15 years (1). The USPSTF based its recommendation on the landmark National Lung Screening Trial (NLST) (2), which provided evidence about the efficacy of screening but did not answer questions about effectiveness when implemented in everyday clinical practice. The recommendation, as noted in an accompanying editorial, leaves ...References1. Moyer VA; U.S. Preventive Services Task Force. Screening for lung cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;160:330-8. [PMID: 24378917] doi:10.7326/M13-2771 LinkGoogle Scholar2. Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, Fagerstrom RM, et al; National Lung Screening Trial Research Team. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365:395-409. [PMID: 21714641] doi:10.1056/NEJMoa1102873 CrossrefMedlineGoogle Scholar3. Detterbeck FC, Unger M. Screening for lung cancer: moving into a new era [Editorial]. Ann Intern Med. 2014;160:363-4. [PMID: 24379025] doi:10.7326/M13-2904 LinkGoogle Scholar4. Medicare Evidence Development & Coverage Advisory Committee. Lung Cancer Screening with Low Dose Computed Tomography [meeting transcript]. Baltimore, MD: Centers for Medicare & Medicaid Services; 30 April 2014. Accessed at www.cms.gov/Regulations-and-Guidance/Guidance/FACA/downloads/id68c.pdf on 2 May 2014. Google Scholar5. Donabedian A. The Definition of Quality and Approaches to Its Assessment. Ann Arbor, MI: Health Administration Pr; 1980. Google Scholar6. Goulart BH, Ramsey SD. Moving beyond the national lung screening trial: discussing strategies for implementation of lung cancer screening programs. Oncologist. 2013;18:941-6. [PMID: 23873718] doi:10.1634/theoncologist.2013-0007 CrossrefMedlineGoogle Scholar7. Detterbeck FC, Mazzone PJ, Naidich DP, Bach PB. Screening for lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143:e78S-92S. [PMID: 23649455] doi:10.1378/chest.12-2350 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From the Veterans Health Administration, Washington, DC.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-1070.Corresponding Author: Linda S. Kinsinger, MD, MPH, National Center for Health Promotion and Disease Prevention, Veterans Health Administration, 3022 Croasdaile Drive, Suite 200, Durham, NC 27705; e-mail, Linda.[email protected]gov.Current Author Addresses: Dr. Kinsinger: National Center for Health Promotion and Disease Prevention, Veterans Health Administration, 3022 Croasdaile Drive, Suite 200, Durham, NC 27705.Dr. Atkins: Office of Research and Development, 810 Vermont Avenue Northwest (10P9H), Washington, DC 20420.Dr. Provenzale: Durham Veterans Affairs Medical Center, 508 Fulton Street (152), Durham, NC 27705.Dr. Anderson: Diagnostic Services, Office of Patient Care Services, Veterans Health Administration, 3022 Croasdaile Drive, Suite 100, Durham, NC 27705.Dr. Petzel: 4621 East Lake Harriet Parkway Minneapolis, MN 55419.Author Contributions: Conception and design: L.S. Kinsinger, D. Atkins, D. Provenzale.Drafting of the article: L.S. Kinsinger, D. Atkins.Critical revision of the article for important intellectual content: L.S. Kinsinger, D. Atkins, D. Provenzale, C. Anderson.Final approval of the article: L.S. Kinsinger, D. Atkins, D. Provenzale, C. Anderson, R. Petzel.Administrative, technical, or logistic support: L.S. Kinsinger.Collection and assembly of data: D. Provenzale.This article was published online first at www.annals.org on 12 August 2014. 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A Survey and Focus Group StudyPrimary Care Providers and a System ProblemAn Official American Thoracic Society/American College of Chest Physicians Policy Statement: Implementation of Low-Dose Computed Tomography Lung Cancer Screening Programs in Clinical PracticeAn Official American Thoracic Society Research Statement: A Research Framework for Pulmonary Nodule Evaluation and ManagementLung Cancer Screening and Elderly Adults: Do We Have Sufficient Evidence?Michael K. Gould, MD, MS 21 October 2014Volume 161, Issue 8Page: 597-598KeywordsDeath ratesHealth careHealth care quality assessmentHealth promotionHealth screeningLung and intrathoracic tumorsLung cancer screeningLungsMedicareVeteran care ePublished: 21 October 2014 Issue Published: 21 October 2014 PDF downloadLoading ...