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Lung cancer screening guidelines were first issued by the United States Preventive Services Task Force in 2013 to help doctors find lung cancer in its earliest stages when it is most treatable, and often curable. Since then, the eligibility guidelines have been revised, and more educational opportunities are available to physicians to help them understand which patients are eligible for lung cancer screening. Nevertheless, only about 5% of eligible patients are screened for lung cancer each year.
The US Preventive Services Task Force suggests annual lung cancer screenings for adults who:
- Are between 50-80 years old, and
- Have a 20-pack-year smoking history, and
- Currently smoke or have quit within the past 15 years, and
- Have no symptoms of lung cancer (asymptomatic)
Research has shown health care disparities based on race and socioeconomic status extend to lung cancer screening. To help address the disparities surrounding lung cancer screening in the Hispanic community, LUNGevity awarded one of the 2022 Health Equity and Inclusiveness Junior Investigator Awards to Coral Olazagasti, MD, medical oncologist at the University of Miami.
LUNGevity spoke with Dr. Olazagasti to understand how her experience improving lung cancer screening rates at a clinic in New York could lead to the first tailored lung cancer screening program for Hispanic patients with a history of head and neck cancer.
LUNGevity Foundation: Why is it important to support lung cancer research?
Dr. Coral Olazagasti: Lung cancer research is important now, more than ever, because lung cancer is still the leading cause of cancer death worldwide. Even though we’ve made good progress in the field in recent years, there’s still a lot of work that needs to be done.
LF: How did you develop an interest in lung cancer screening?
CO: When I was doing my residency in New York, I was working with a world-class thoracic oncologist, and I realized the majority of new patients in the clinic had stage IV lung cancer. This was surprising because in the previous year, lung cancer screening had just been approved in the US. I expected most of the new cases would be diagnosed through screening and we would be detecting lung cancer early when it’s the most treatable.
This sparked my curiosity and I decided to analyze the lung cancer screening patterns at our clinic to get a sense for how we were doing. The answer? We weren’t doing great.
LF: What did you do to improve the screening rates for the patients in your clinic?
CO: I started by surveying our physicians to understand the barriers. I found that there were several different reasons eligible patients were not getting screened for lung cancer. One big reason was because lung cancer screening was recently approved, and physicians didn’t know about it or didn’t know the specifics of the eligibility guidelines. Many physicians weren’t sure about insurance coverage, and others wondered what to do with the results when they came back. There was also the issue of time management. With only 20 minutes to meet with patients, many physicians didn’t have time to discuss screening recommendations.
So, I decided to create a lung cancer screening educational program tailored to residents and physicians. It was a series of lectures discussing the landmark trials in lung cancer screening, shared decision-making discussions, and lung cancer screening guidelines over the course of a nine-month period. After the lecture series, I found the rates of lung cancer screening uptake to dramatically increase in our practice.
LF: How did this preliminary work turn into a research project funded by LUNGevity?
CO: During my fellowship, I did a similar study that showed 96% of eligible patients were not being screened for lung cancer. And the screening rate was even worse for non-White Hispanics. I saw a need to help this underserved population. And, as a Hispanic woman myself, this was an area I was passionate about.
In my practice, I am committed to the health of my patients. I see a lot of patients who are survivors of head and neck cancer. A secondary analysis from the National Lung Screening Trial showed that these patients have a 13% cumulative risk of developing lung cancer, almost double that of the general population in the study. As an attending physician, I can focus on merging my love of my Hispanic community and my passion for my patients and lung cancer screening into my research project.
With the support from LUNGevity, I’m pleased to be conducting a survey to understand the barriers to lung cancer screening in Hispanic patients with a history of head and neck cancer. The goal of this work will be to develop the first lung cancer screening program tailored to Hispanic survivors of head and neck cancer.
LF: How has this research award impacted your career?
CO: This award is the breakthrough in my career as a physician-scientist. It’s a platform to grow my research and it provides the necessary funds, mentorship, and support to help me pursue my goal of closing the diversity gap in lung cancer screening in the Hispanic population. I’m so grateful for this opportunity.
The LUNGevity Early Lung Cancer Center uses research, policy, partnerships, and education to increase early detection rates so people with lung cancer have the best chance at long-term survival. Learn more here.