Lung cancer is the leading cause of cancer-related death among men and women in the U.S. and worldwide. For many decades, lung cancer was the sole cancer among the deadly four without an evidence-based screening method for decreasing mortality. This changed in November 2011, when findings from the National Lung Cancer Screening Trial showed low-dose lung CT screening was more efficacious in reducing deaths in high-risk individuals than conventional radiography. As such, an ever-increasing number of health organizations now recommend this screening protocol. Lung Cancer Screening by Mark Parker and esteemed VCU Health colleagues, fulfills the dire need for a comprehensive guide explaining the crucial aspects of lung cancer screenings. The first two chapters lay a foundation with discussion of lung cancer epidemiology and risk factors beyond cigarette smoking. Subsequent chapters cover the fundamentals, with clinical pearls on setting up a successful lung cancer screening program, patient eligibility criteria, imaging variances of tumors in the lungs, screening pros and cons, and interpreting/reporting screening results. The evolution and future of lung cancer screenings Detection and management of unexpected incidental pulmonary and non-pulmonary findings Discussion of test cases utilizing the Lung-RADSTM risk-stratifying system for low-dose chest CT screenings Benefits and potential harms associated with mass lung cancer screening programs including false positive, false negative, and over-diagnosis rates This state-of-the-art guide is essential reading for radiologists, oncologists, pulmonologists, and internists. It is a must-have bookshelf reference for hospital radiology and oncology departments, in particular for those setting up new lung cancer screening programs.

Lung cancer is the second most diagnosed cancer and remains the leading cause of cancer-related deaths in the United States. The high mortality is largely the consequence of late diagnosis; lung cancer is typically asymptomatic in early stages when a surgical cure is most likely. As a result, there has been great interest in and research on early detection of lung cancer through screening. There is evidence for reduced disease-specific mortality through screening for lung cancer. However, creating an integrated, systematic approach to lung cancer screening remains a challenge for providers. A successful lung cancer screening program weighs the benefits and harms of screening, clearly defines the target population and the screening process, and does not exclude eligible patient populations based on race, ethnicity, or socioeconomic status, In addition it should promote shared decision-making and address risk reduction. Lung Cancer Screening: Essentials for Primary Care provides a comprehensive and pragmatic guide to screening for lung cancer in real world clinical practice. The first two chapters summarize the epidemiology, risk factors and disparities in lung cancer, and provide the evidence base for screening for lung cancer. The disparities in lung cancer among different groups within the US population are well known. This text highlights how health disparities in lung cancer affect screening and have led to modification of lung cancer screening guidelines. Subsequent chapters provide a guide to implementing a successful lung cancer screening program and address the barriers that arise during implementation. The book concludes with real-world solutions to overcoming barriers in lung cancer screening. This pocket guide is an essential read and bookshelf reference for providers who do not have the specialized knowledge of screening for lung cancer. It also appeals to pulmonologists, fellows in Pulmonary Medicine, chest radiologists, and advanced practice providers with an interest in setting up lung cancer screening in any clinical practice.

Lung cancer is the leading cause of cancer-related death among men and women in the U.S. and worldwide. For many decades, lung cancer was the sole cancer among the deadly four without an evidence-based screening method for decreasing mortality. This changed in November 2011, when findings from the National Lung Cancer Screening Trial showed low-dose lung CT screening was more efficacious in reducing deaths in high-risk individuals than conventional radiography. As such, an ever-increasing number of health organizations now recommend this screening protocol. Lung Cancer Screening by Mark Parker and esteemed VCU Health colleagues, fulfills the dire need for a comprehensive guide explaining the crucial aspects of lung cancer screenings. The first two chapters lay a foundation with discussion of lung cancer epidemiology and risk factors beyond cigarette smoking. Subsequent chapters cover the fundamentals, with clinical pearls on setting up a successful lung cancer screening program, patient eligibility criteria, imaging variances of tumors in the lungs, screening pros and cons, and interpreting/reporting screening results. The evolution and future of lung cancer screenings Detection and management of unexpected incidental pulmonary and non-pulmonary findings Discussion of test cases utilizing the Lung-RADSTM risk-stratifying system for low-dose chest CT screenings Benefits and potential harms associated with mass lung cancer screening programs including false positive, false negative, and over-diagnosis rates This state-of-the-art guide is essential reading for radiologists, oncologists, pulmonologists, and internists. It is a must-have bookshelf reference for hospital radiology and oncology departments, in particular for those setting up new lung cancer screening programs.

This book is a comprehensive guide to lung cancer screening for clinicians, healthcare systems, community leaders, and public health officials with the hope of creating a more equitable landscape in both lung cancer screening and lung cancer-related outcomes, at local, state, and national levels. Authors take a new approach to primary and secondary lung cancer prevention that is in the early stages of adoption in the United States. The last decade ushered in recognition of screening as an effective intervention, but unfortunately, despite the wide acceptance of the importance of this new screening modality, nationally, not more than 5% of eligible subjects have undergone screening to date in the United States, although in some states uptake has reached as high as 16%. As is common with any new preventive cancer screening, racial and socioeconomic disparities emerge in utilization, stage at diagnosis, and mortality. Over time, these disparities decline, but consequential differences endure. Therefore, it is critical to establish equitable screening practices. The true measure of the effectiveness of any lung cancer screening program needs to be viewed through the lens of its impact on populations, including those most affected by the morbidity and mortality of smoking-related illness and lung cancer. As such, this book emphasizes a number of important public health topics, including community outreach to vulnerable populations, social justice issues, addressing stigma and fatalism in the general community, and the use of geocoding to assess a program’s impact at a population level. This book weaves traditional topics related to lung cancer screening, such as promoting initial and repeat screening, interpreting Lung RADs, and managing the follow-up of findings, into the population perspective in order to present a unified, comprehensive approach to the subject. Further, it serves as a guide that health systems, health care professionals, community leaders, and other stakeholders can use to achieve the promise of lung cancer screening.

The public health burden from lung cancer is substantial: it is the second most commonly diagnosed cancer and the leading cause of cancer-related deaths in the United States. Given the individual and population health burden of lung cancer, especially when it is diagnosed at later stages, there has been a push to develop and implement screening strategies for early detection. However, many factors need to be considered for broad implementation of lung cancer screening in clinical practice. Effective implementation will entail understanding the balance of potential benefits and harms of lung cancer screening, defining and reaching eligible populations, addressing health disparities, and many more considerations. In recognition of the substantial challenges to developing effective lung cancer screening programs in clinical practice, the National Academies of Sciences, Engineering, and Medicine held a workshop in June 2016. At the workshop, experts described the current evidence base for lung cancer screening, the current challenges of implementation, and opportunities to overcome them. Workshop participants also explored capacity and access issues; best practices for screening programs; assessment of patient outcomes, quality, and value in lung cancer screening; and research needs that could improve implementation efforts. This publication summarizes the presentations and discussions from the workshop.

This book provides teaching scripts for medical educators in internal medicine and coaches them in creating their own teaching scripts. Every year, thousands of attending internists are asked to train the next generation of physicians to master a growing body of knowledge. Formal teaching time has become increasingly limited due to rising clinical workload, medical documentation requirements, duty hour restrictions, and other time pressures. In addition, today’s physicians-in-training expect teaching sessions that deliver focused, evidence-based content that is integrated into clinical workflow. In keeping with both time pressures and trainee expectations, academic internists must be prepared to effectively and efficiently teach important diagnostic and management concepts. A teaching script is a methodical and structured plan that aids in effective teaching. The teaching scripts in this book anticipate learners’ misconceptions, highlight a limited number of teaching points, provide evidence to support the teaching points, use strategies to engage the learners, and provide a cognitive scaffold for teaching the topic that the teacher can refine over time. All divisions of internal medicine (e.g. cardiology, rheumatology, and gastroenterology) are covered and a section on undifferentiated symptom-based presentations (e.g. fatigue, fever, and unintentional weight loss) is included. This book provides well-constructed teaching scripts for commonly encountered clinical scenarios, is authored by experienced academic internists and allows the reader to either implement them directly or modify them for their own use. Each teaching script is designed to be taught in 10-15 minutes, but can be easily adjusted by the reader for longer or shorter talks. Teaching Scripts in Internal Medicine is an ideal tool for internal medicine attending physicians and trainees, as well as physician’s assistants, nurse practitioners, and all others who teach and learn internal medicine.

Lung Cancer Screening is reviewed extensively in this important Thoracic Surgery Clinics of North America issue. Articles include: CT screening: The Early Lung Cancer Action Program Experience; Lung Cancer Screening: The Mayo Experience; National Lung Screening Trial; Health Risks from CT Lung Cancer Screening; The European Perspective of Lung Cancer Screening; Surgeons and Lung Cancer Screening: Rules of Engagement; The National Comprehensive Cancer Network Recommendations for Lung Cancer Screening; The United States Preventive Services Task Force Recommendations for Lung Cancer Screening; Current Estimate of Costs of Lung Cancer Screening in the US; Refining Strategies to Identify Population to be Screened for Lung Cancer; Long-term Oncologic and Financial Implications of Lung Cancer Screening; and more!