Eastern Cardiothoracic Surgical Society

Improving Lung Cancer Diagnosis and Treatment in a Community Hospital Setting
Joseph D. Whitlark, Tyler Singer, Ava M. Whitlark, Ben Steward, Mount Nittany Medical Center, State College, PA, USA


OBJECTIVE: Lung cancer is the leading cause of cancer-related death in the United States. The earlier lung cancer is detected, the higher the average 5-year survival rate. This difference in survival is the impetus behind lung cancer screening programs. In a community hospital setting, several changes were implemented to address this problem. A lung cancer screening program was instituted and newer interventional diagnostic capabilities were introduced with surgical oversight. In particular, dedicated thoracic surgical participation in multidisciplinary cancer conferences and the work up of potential surgical patients allowed earlier surgical involvement with these patients.

METHODS: We compared the 18-month period before the implementation of these changes to the 30-month period after these changes were instituted.

RESULTS: The incidence of stage I disease increased from 23% to 37% of all lung cancer patients seen, stage II patients increased from 6% to 9%, stage III patients decreased from 22% to 12%, and stage IV patients decreased from 44% to 28%. The percentage of lung cancer patients undergoing surgery increased from 23% to 44%. The overall number of lung cancer patients also increased.

CONCLUSIONS: Improving lung cancer diagnoses and treatment at earlier stages can be effected by implementing changes such as we have noted. Instituting a lung cancer screening program, up-to-date interventional diagnostic capabilities, and especially thoracic surgical involvement in the work-up and management of these patients may lead to earlier diagnoses and treatment with improved survival.