Lung cancer screening program quality indicators - review & recommendations - An International Association for the Study of Lung Cancer Delphi process study.
Martin C Tammemägi, Andrea Borondy-Kitts, John K Field, Claudia I Henschke, Anant Mohan, Anna Kerpel-Fronius, Luigi Ventura, Dawei Yang, Long Jiang, Coenraad Fn Koegelenberg, Milena Cavic, Haval Balata, Lucia Viola, Javier J Zulueta, Ricardo Sales Dos Santos, Witold Rzyman, David F Yankelevitz, Annette McWilliams, Stephen Lam, Ella A Kazerooni, Rudolf M Huber
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Abstract
Introduction: Lung cancer screening (LCS) using low-dose-computed tomography reduces lung cancer mortality in high-risk individuals. Evaluating and monitoring LCS programs are important to ensure and improve quality, efficiency and participant outcomes. There is no agreement on LCS quality indicators (QIs).
Methods: Twenty multidisciplinary members of IASLC used a Delphi process to develop consensus Qis. They considered 50 Qis during information/discussion sessions and two anonymous voting rounds. ≥80% voting agree/strongly agree on a five-point Likert scale determined consensus.
Results: Twenty essential and six desirable QIs were identified in 10 of 11 LCS pathway domain categories: ENTRY: Proportion eligible who got screened. SMOKING_CESSATION: Proportion current-smoking individuals offered cessation interventions.
Outcomes: Cancer detection rate, stage distribution, interval cancer rate HARMS: Number/proportion of serious complications following invasive procedures, non-lung cancer diagnoses following invasive procedures, or following surgery, 30-day mortality following invasive procedure.
Treatment: Proportion early-stage cancers receiving treatment with curative intent. WAIT_TIMES: Suspicious-for-lung-cancer scan to definitive diagnosis, curative-intent treatment for individuals with early-stage disease, scan completion to reporting results to PCP/participant.
Equity: Race/sex/socioeconomic differences in adherence to regular screens, early-stage cancer treatment, offer of smoking cessation interventions, clinical investigation of suspicious-for-lung-cancer screens.
Discussion: Review among panel members provide recommended LCS QIs that should be considered in development of LCS initiatives .
期刊介绍：
Journal of Thoracic Oncology (JTO), the official journal of the International Association for the Study of Lung Cancer,is the primary educational and informational publication for topics relevant to the prevention, detection, diagnosis, and treatment of all thoracic malignancies.The readship includes epidemiologists, medical oncologists, radiation oncologists, thoracic surgeons, pulmonologists, radiologists, pathologists, nuclear medicine physicians, and research scientists with a special interest in thoracic oncology.
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