Virtual lung cancer screening as a substitute to in-person screening

November 2021 Health Innovation Nalinee Pathak

During the COVID-19 pandemic, several lung cancer patients had to postpone their regular screening, causing a 75% decrease in lung cancer screenings (LCS). A group of researchers at Temple University in Philadelphia adopted an alternative approach of telemedicine lung cancer screening for their patients.

Retrospective comparison of personal visit versus telemedicine

A retrospective study comparing virtual screening visits versus in-person screening was carried out by Erkmen et al, and recently presented at the American College of Surgeons Virtual Clinical Congress. The study included 1,113 patients, of whom 673 patients received single-visit LCS before the COVID-19 pandemic, and the remaining 440 opted for single encounter telemedicine LCS, since March 2020. Several characteristics of patients in both groups were assessed including race, smoking history, education attained, lung-RADS, cancer diagnosis and stage, and adherence to follow-up recommendations. Most of the screened patients were African Americans comprising 52% and 37% in before and after pandemic groups, respectively. Also, 65% patients who visited hospital were active smokers in comparison to 33% who were virtually screened. 

Analysis of the study revealed that the lung-RADs results between both types of visits were quite similar (single visit vs. telemedicine). A similar trend was observed in the frequency of procedures for cancer diagnosis between both groups. For example, CT guided biopsy was 0.4% in the single visit group vs 0.5% in telemedicine screening. This similarity was also observed for other procedures such as RBUS guided biopsy, surgery, declined diagnostic work up and deceased prior to diagnostic work up.

These findings suggest that telemedicine screening is on par with in-person screening, and thus could become an effective procedure for screening a larger number of patients. Importantly, this method could also be extended to screening of other cancers.

Reference

Margarinos JS, et al Implementation of a Novel, Single-Encounter Telemedicine Lung Cancer Screening (SET-LCS) During Covid-19 Preserves Access among African Americans. Scientific Forum Presentation. American College of Surgeons Clinical Congress 2021.

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