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Lung cancer screening is underused nationwide, particularly in rural areas where incidence and mortality rates are high, suggesting the need for innovative methods to reach underserved populations. Partners from national, state, and community positions can combine the service and science needed to save lives with mobile lung cancer screening.

There is a growing population of lung cancer survivors who may have unmet physical, psychological, and practical needs as they transition from active treatment into recovery. The specific needs and best ways to meet them are unclear in this population. This paper describes the development and outcomes of a program aimed to transition patients to survivorship. Patients with early-stage lung cancer were assessed for the presence and severity of unmet physical, psychological, and practical needs at the end of active treatment. Patients also attended a multidisciplinary clinic visit to create an individualized survivorship care plan and provide appropriate referrals. They were surveyed 3 months later to assess effectiveness of the program. Eighty-four participants were enrolled in the program. All reported at least one unmet need, with a mean of seven unmet needs, particularly related to breathing, fatigue, pain, and fear/anxiety. Following program participation, there were fewer and/or less severe needs. The Bridge program identified and decreased the number and severity of unmet needs through connecting survivors to local resources. Challenges to program implementation included hesitancy of providers to refer, time constraints of survivors and staff, and lack of community resources, especially for identified mental health needs.

Introduction: WVU Cancer Institute’s Cancer Prevention and Control (CPC) and the Patient Advocate Foundation (PAF) is working to address lung cancer disparities in West Virginia (WV). Their goal is to decrease lung cancer mortality, the leading cause of cancer deaths in WV, and improve early diagnosis of lung cancer in the state. Brief Description: In 2016 there was no infrastructure for lung cancer screening in WV. The rural state’s significant geographic barriers, low socioeconomic status, lack of lung cancer screening facilities, and limited provider knowledge regarding screening guidelines created substantial challenges. The major aim of the WV Lung Cancer Project (WVLCP) is to increase lung cancer screening among low-income and limited resourced individuals across WV. The project has three primary components: provider outreach and engagement; patient awareness and education; and case management support. Summary of Data: The WVLCP initially developed a case management (CM) protocol with one of the major Medicaid Managed Care Organizations (MCO) in the state in order to reach those eligible for screening and navigate them to primary care providers for care. The result of protocol implementation was the identification of lack of provider knowledge. The team then surveyed health care providers to further assess their knowledge, attitudes, beliefs, and practices regarding lung cancer screening. The results indicated a need for education on the screening guidelines, including recommended test, frequency, eligibility, and insurance coverage. As a result, project staff provided academic detailing to health care providers and created a continuing education webinar. Beyond the need to enhance health care provider understanding, there was a need to educate the public about lung cancer screening and the location of services. To enhance patient awareness and education, the project established and promoted the WV Lung Cancer CareLine and participated in community education events. Between 2016 and 2019, American College of Radiology (ACR) screening facilities increased from five to 24 sites. The WVLCP was able to facilitate the addition of 12 sites to the ACR Registry by working one-on-one with various health care entities during this time. Two of the MCOs fully implemented the CM protocol. Thousands of patients were assessed, hundreds referred to a primary care provider, tens were screened, and two cases of lung cancer were found. As a result, both companies incorporated the protocol into their operations and have case managers contacting patients to reduce barriers to screening. Conclusion: By partnering with care providers, the public, and health insurance payors, the project has expanded the lung cancer screening infrastructure in WV. As the project concludes in 2019, the state’s comprehensive cancer coalition, Mountains of Hope, will work to promote lung cancer screening in WV and continue the efforts of PAF and the WVUCI. Note: This abstract was not presented at the conference. Citation Format: Stephenie K Kennedy-Rea, Shonta Chambers, Lauren Hixenbaugh. West Virginia Lung Cancer Project [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C117.

Introduction: The goal of the Bridge Program is to improve the overall coordination of care, increase quality of life, and decrease the consequences of treatment for patients diagnosed with lung cancer. Brief Description: Patients diagnosed with late stage lung cancer are often referred to supportive or palliative care programs that provide symptom management, psychosocial support and follow up, as well as advanced planning. In contrast, the needs of patients diagnosed at a curable or early stage often go unaddressed. The focus of the Bridge Program is to develop and implement a comprehensive survivorship program for Stage 1-3 lung cancer patients completing curative treatment. The Bridge Program enrolls and assesses patients at the end of cancer treatment utilizing a multidisciplinary team approach. The Program’s goal is to improve patient and caregiver quality of life in the major life domains of physical, social, psychological, and spiritual. We see this program bridging patients from active cancer care to the next step on their journey in life. Using a multidisciplinary team approach creates an opportunity for collaboration and information sharing that leads to the development of an enhanced survivorship care plan. Summary of Data: Between March 2017 and June 2019, the Bridge Program enrolled 81 patients across three locations. At the end of cancer care, 100% of these patients had at least one unmet need and nearly half had seven or more. Assessment identified a total of 540 unmet needs which resulted in 132 clinician referrals. When categorizing unmet needs into physical, practical, and emotional domains, Bridge patients identified more unmet needs in the physical category than any other. The most common referrals were for Physical Therapy and Occupational Therapy. Following enrollment into the Program, 93% of Bridge patients showed a decrease in the number of unmet needs at their first recurrence and monitoring visit. When comparing a cohort of Bridge enrolled verses non-Bridge patients, we found that prior to visiting the Emergency Department, Bridge patients contacted their treatment team at a higher rate than non-Bridge patients and that the completion of Survivorship Care Plans was 100% for Bridge patients and only 38% for non-Bridge patients. Conclusion: Lung cancer patients have many unmet needs following active treatment for lung cancer. The Bridge Program addresses a cancer that is not frequently talked about in survivorship care: lung cancer. With increased screening and improvements in treatment, we can anticipate an increase in the number of lung cancer survivors. The Bridge Program provides a novel patient-centered model that addresses a cohort of patients that are often older and sicker than other cancer patients. Note: This abstract was not presented at the conference. Citation Format: Stephenie K Kennedy-Rea, Anne Swisher, Adrienne Duckworth, Tara Miller, Salman Osmon, Abby Starkey, Megan Burkart, Garth Graebe, Mary Anne Yanosik, Rachel Harper, Amy Allen. Bridge to Good Living: Thriving beyond lung cancer in West Virginia [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D059.