Center for Health Equity Research and Promotion

Study of new tools for Veterans at risk for lung cancer. (Photo for illustrative purposes only.)

Lung cancer is the leading cause of cancer deaths in the U.S., and Veterans have a higher risk of developing lung cancer due to their older age and smoking history.  Recent clinical trials provide evidence that screening with low dose CT scans will decrease lung cancer and all-cause mortality among older heavy smokers.  However, a VA HSR&D pilot study led by Marilyn Schapira, MD, MPH, showed that some Veterans are highly reluctant to be screened for lung cancer and enter the care pathway that they perceive to be harmful.

“While evidence clearly shows the benefits and harms of screening, many people don’t have the tools they need to make a decision that reflects their personal preferences,” says Dr. Schapira.  “We’re developing a web-based screening decision tool that incorporates both patient and provider input so Veterans can weigh the pros and cons of their individual situation.” 

Now Dr. Schapira has received notification of VA HSR&D’s intent to fund a merit review study on “Incorporating Veterans’ Preferences into Lung Cancer Screening Decisions.”   This is a multi-site study at the New Haven and Crescenz (Philadelphia) VA Medical Centers that will develop and evaluate a shared decision-making support tool for Veterans considering lung cancer screening.

This merit review builds directly upon the pilot study:  http://www.hsrd.research.va.gov/research/abstracts.cfm?Project_ID=2141703157

The merit review study will be conducted by a multi-disciplinary team across the two VA sites. Results of this study will provide tools that can be used to integrate lung cancer screening into clinical practice at VA Medical Centers in a patient centered approach.

The specific aims of this study are to 1) elicit patient and provider stakeholder input to inform the development of a lung cancer screening decision tool, 2) develop a web based Lung Cancer Screening Decision Tool (LCSDecTool) that incorporates patient and provider input, and 3) evaluate the impact of the LCSDecTool compared to usual care on the decision process, clinical outcomes, and quality of life.

Dr. Schapira is working closely with the US Department of Veterans Affairs National Center for Health Promotion and Disease Prevention to integrate the tools and paradigm developed to primary care in the VA Medical Care System. The work builds directly upon a recently completed HSR&D pilot support in the area of lung cancer and shared decision making.

The contents of this article and this website do not represent the views of the Department of Veterans Affairs or the US government.