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for eligible individuals, and free treatment for those who receive a lung cancer diagnosis. CCCP programs provide a safety net for uninsured and underinsured Delawareans who are unable to access LDCT screening through traditional insurance. By furthering existing partnerships among the DCC, DPH, and the MSD, Delaware’s public health and medical communities can leverage CCCP programs to advance the shared goal
of reducing lung cancer incidence and mortality in Delaware.
We encourage Delaware providers to identify patients at elevated risk for lung cancer and discuss with them
the appropriateness of LDCT. ACS recommends that clinicians underscore that LDCT detects some lung cancers early, substantially reducing the risk
of dying from the disease.11 Clinicians should also discuss two primary drawbacks associated with LDCT: (a) LDCT will not detect all lung cancers and not all patients with lung cancer detected via LDCT will avoid death from lung chance of a false positive screening result associated with LDCT, there is a small rate of invasive procedures following a false positive.11 Providers should remind patients that LDCT is not a substitute for smoking cessation and refer them to a smoking cessation program such as the Delaware Quitline.
CONCLUSION
Aggressive, comprehensive statewide tobacco prevention efforts have contributed to reductions in the number of Delawareans using tobacco, as well as statewide lung cancer incidence and mortality rates. Delaware’s existing statewide cancer infrastructure facilitates LDCT screening high-risk Delawareans. To further reduce Delaware’s lung cancer burden, providers should order annual LDCT screenings
for Delawareans at high risk for lung cancer to increase the proportion of lung cancer cases detected in the earliest, most treatable stages. The opportunity for early diagnosis of additional chronic diseases through LDCT screening, especially among older Delawareans, will further reduce overall morbidity and mortality and generate substantial cost savings
for the state.
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CONTRIBUTING AUTHOR
■ KARYL T. RATTAY, MD, MS, is the Director of the nationally accredited Division of Public Health (DPH) within the Delaware Department of Health and Social Services. As Delaware’s State Health Officer,
Dr. Rattay leads nearly 700 employees upholding DPH’s vision: healthy people in healthy communities.
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Del Med J | September/October 2019 | Vol. 91 | No. 5