Telehealth May Increase Access to Quality Lung Cancer Screenings

Using telehealth for lung cancer screenings was just as effective as in-person screenings and may help increase screening rates, a study out of Temple University Hospital found.

In-person care became difficult when the COVID-19 pandemic hit in March 2020. Per CMS and other regulatory guidance, many healthcare organizations hit pause on preventive care screenings in order to reallocate staff and reduce the risk of virus transmission.

Like other organizations, Temple University physicians started offering virtual lung cancer screenings for patients in order to minimize the risk of COVID-19 exposure.

The retrospective study compared 673 patients who received an in-person lung cancer screening before the pandemic with 440 patients who received a lung cancer screening via telehealth since March 2020. Both visit types were one-encounter appointments.

The researchers looked at smoking history, educational status, race, cancer diagnosis and stage, adherence to follow-up appointments, and Lung-RADS to compare the two different groups of patients.

According to the American College of Radiology, Lung-RADS is a “quality assurance tool designed to standardize lung cancer screening CT reporting and management recommendations, reduce confusion in lung cancer screening CT interpretations, and facilitate outcome monitoring.”

There were no significant differences in Lung-RADS results between the in-person and telehealth group, the study found. The researchers also found no significant difference in the number of procedures for cancer diagnoses, including CT guided biopsy, endobronchial ultrasound guided biopsy, and surgery.

These results indicate that the lung cancer screenings performed via telehealth were just as effective as the in-person screenings.

Many of the patients who received lung cancer screenings at Temple University Hospital were Black, with Black patients accounting for 52 percent of in-person screenings and 37 percent of telehealth screenings.

Black and African American individuals face heightened care disparities when it comes to health conditions, including lung cancer. Compared to the general population, they are less likely to receive screenings and treatment for lung cancer and are more likely to die from the disease, the study authors noted.

Offering virtual screenings may be more convenient and could increase utilization among this high-risk population, according to Jessica Magarinos, MD, a general surgery resident at the hospital and first author of the study.

“Our study shows that telemedicine screenings were able to reach the African American population in a safety net hospital,” Magarinos said in the press release.

Using telehealth may also help everyone who is eligible for a lung cancer screening receive evaluations at the recommended intervals.

Only around 3 to 6 percent of eligible candidates get screened for lung cancer, according to Cherie Erkmen, MD, a thoracic surgeon at Temple University Hospital and the principal investigator on the study. The annual mortality rate for lung cancer is higher than any other type of cancer but early detection increases the chances of successfully treating the disease, the researchers stated.

Lung cancer screenings during the COVID-19 pandemic dropped by 75 percent even though telehealth facilitated many screenings in place of in-person visits. The researchers said they hope health systems continue to employ telehealth for lung cancer screenings after the pandemic is over to increase accessibility and help tackle obstacles to getting screened.

Before the COVID-19 pandemic, the University of Alabama at Birmingham launched a telehealth program to help rural Alabama residents at risk for lung cancer access cancer specialists. Patients with radiographic studies that indicated a potential for lung cancer could access specialists via a telehealth portal to determine if they needed additional care.

Additionally, the Temple University Hospital researchers expressed that telehealth could be used to screen for other types of cancer. Other health systems have used mHealth applications and telehealth programs to increase access to and encourage colon cancer screenings and breast cancer screenings.