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National Framework for Lung Screening Excellence

National Framework

Uniting the At-Risk Public with Responsible Medical Care Now

Declaration of Purpose

Lung cancer kills more Americans than the next four leading cancers combined, including breast and prostate cancers. Low dose CT screening for lung cancer carried out safely, efficiently and equitably will save tens of thousands of lives a year. Drawing on the knowledge acquired from other screening histories and from the recent validation of the effectiveness of CT screening in a high risk population, it is clear that achieving this goal will require a well-informed public and the commitment of medical professionals, researchers and industry to institute best practices.

Part One: The Rights of the People

Empowering consumers to make informed health decisions

  • You have the right to know if you are at risk for lung cancer.
  • You have the right to know that well organized low dose CT screening has been shown to significantly reduce the possibility of dying from lung cancer.
  • You have the right to clear and unbiased information on the risks and benefits of CT screening.
  • You have the right to fair and equitable access to medically appropriate CT screening.
  • You have the right to timely and compassionate care if you are diagnosed with lung cancer.
  • You have the right to donate your scans and biological specimens to lung cancer research to help find additional life saving cures.
  • You have the right to ask screening sites if they follow the Guiding Principles for Lung Cancer Screening Excellence and provide care in a multi-disciplinary continuum.

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Part Two: The Guiding Principles for Centers of Excellence Offering Lung Cancer Screening in the Continuum of Care

Broad principles to guide best practices

  • Provides clear information, based on current evidence, on who is a candidate for lung cancer screening and the risks and benefits of the screening process in language appropriate to the candidate.
  • Complies with comprehensive standards based on best practices for controlling screening quality, radiation dose and diagnostic procedures such as those developed by the National Comprehensive Cancer Network and the International Early Lung Cancer Action Program.
  • Works with a multi-disciplinary clinical team to carry out a coordinated continuum of care for screening, diagnosis and disease management based on best practices which include:
    • Experienced radiologists, pathologists and pulmonologists to evaluate the images and specimens obtained in screening and treatment work-ups;
    • Trained thoracic surgeons with experience in minimally invasive techniques who are committed to annual reporting on surgical outcomes;
    • Oncologists and radiation oncologists experienced in the care of patients with lung cancer;
    • Nurses and support staff who will assist patients with coordination of their care within the continuum.
  • Includes a comprehensive smoking cessation program in its screening and continuum of care program based on best practices evidence.
  • Reports results expeditiously to those screened and the referring physician, and will transmit copies of all reports and scans in a timely manner if requested for a second opinion or transfer of care.
  • Provides those screened with information on how they can donate images and biospecimens to advance research in the prevention, diagnosis and treatment of all types of lung cancer.
  • Participates in outcome data collection in order to further refine risk evaluation, screening and diagnostic protocols.

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Part Three: Screening Excellence Forum

Commitment to an ongoing quality improvement process

Advances in imaging and biomedical research will continue to evolve rapidly. The introduction of CT screening into the healthcare system presents a unique opportunity to develop a concurrent mechanism for collecting data and specimens to accelerate that research and for introducing refinements into the screening process as imaging and biomedical advances occur and are validated.

LUNG CANCER ALLIANCE commits to the following:

  • Convene the Lung Cancer Screening Excellence Forum to develop the mechanism for data collection and for incorporating quality improvements into the process of screening and the continuum of care.
  • Continue to provide responsible and timely information on lung screening and research advancements to the public.
  • Continue to inform the public of those sites committed to providing lung cancer screening within a continuum of care following best practices.
  • Continue to work collaboratively with the medical community to provide the public and patient perspective.
  • Continue to support research in imaging, targeted therapies and the molecular signatures of precancerous cellular environments, risk and malignancy for all types of lung cancers.
  • Continue to work with all stakeholders to support measures to reduce tobacco exposure in our society as well as to collaborate with partners to address issues contributing to the stigmatization of lung cancer and work to reduce disparities in the delivery of quality lung cancer screening services.

We gratefully acknowledge the leadership contributions of William R. Mayfield, M.D., Chief Surgical Officer for WellStar Health Systems, current member of The Society of Thoracic Surgeons, Board Certified in Cardiovascular and Thoracic surgery, James Mulshine, MD, Associate Provost for Research at Rush Medical University and Frederic Grannis, Jr., MD, President of City of Hope Medical Staff in the creation of this Framework.

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