Page 18 - Deleware Medical Journal - September/October 2019

Early Lung Cancer Screening in Delaware:
Providers and Public Health, Partnering to Save Lives
Karyl T. Rattay, MD, MS
Lung cancer is the most commonly diagnosed cancer
and the leading cause of cancer death in Delaware. From 2011 to 2015, lung cancer accounted for 19% of newly diagnosed cancers — the largest share of any single cancer type — and 29% of cancer deaths. Delaware’s 2011-2015 lung cancer incidence and mortality rates were significantly higher than the comparable U.S. rates. Only 22% of Delaware lung cancer cases diagnosed in 2011-2015 were local-stage diagnoses; over half (52%) of all Delaware lung cancer cases were diagnosed in the distant stage after metastasizing to distant tissues, organs, or lymph nodes.
Historically, Delaware has had one of the highest tobacco use rates in the U.S. However, nearly two decades of successful tobacco control efforts have reduced statewide tobacco-use prevalence. As a result, from 2001-2005 to 2011-2015, Delaware’s lung cancer incidence and mortality rates fell 10% and 19%, respectively. To extend these public health successes and further improve population
health outcomes, Delawareans at high risk for lung cancer should be screened annually in accordance with National Comprehensive Cancer Network (NCCN) low-dose computed tomography (LDCT) scan screening guidelines. Despite the demonstrated effectiveness and cost-effectiveness of LDCT, its ability to detect additional chronic conditions, and its coverage by most private and public insurance options, the medical community has been hesitant to champion LDCT as an important tool to reduce lung cancer morbidity and mortality in Delaware.
DPH seeks to partner with providers to help Delawareans understand their personal lung cancer risk, provide access to high-quality LDCT lung cancer screening when appropriate, and ensure follow-up care in the event of
a lung cancer diagnosis. Our existing statewide cancer infrastructure positions Delaware to capitalize on the public health opportunities afforded through LDCT, especially for low-income or otherwise vulnerable populations.
210 Del Med J | September/October 2019 | Vol. 91 | No. 5
Abstract