How Siteman is revolutionizing lung cancer screening and improving patient outcomes

In 2021, the U.S. Preventive Services Task Force (USPSTF) replaced the 2013 USPSTF lung cancer screening guidelines. As a result, many more people at high risk for lung cancer were able to get screened. First, the new guidelines lowered the youngest eligible age for screening from 55 to 50 years. They also reduced the 30 pack-year smoking history (or an overall average of one pack smoked per day for 30 years) to 20 pack-years. It is expected that these guidelines will prevent more lung cancer deaths, and may help reduce racial disparities in lung cancer screening.

Our lung cancer screening program

When Siteman first established its lung cancer screening program in September 2016, Barnes-Jewish Hospital was the sole screening location with just one nurse navigator. Now, we offer screenings at seven Siteman locations with three nurse navigators. Our multidisciplinary steering committee meets quarterly to review program progress and set program goals to ensure that we are meeting patient needs. Regular review of the program means that our patients receive the best care possible.

First, nurse navigators help explain results and send referrals to a pulmonologist or Washington University thoracic surgeon. These specialists then monitor and manage abnormalities that may be the result of lung cancer. We also use the Epic Lung Screening module, which optimizes patient tracking and follow-up.

At Siteman, our specialists support patients through every step of their lung health journey. This begins with careful screening for lung cancer and includes documenting other lung abnormalities caused by smoking.

What advantages does Siteman’s lung cancer screening program offer patients compared to other programs?

Lung specialists at Siteman provide best-in-class care at each stage of the screening process. Compassionate nurse navigators help patients understand their results before sending referrals to a specialty nodule clinic. Then, world-class physicians who specialize in the diagnosis and treatment of lung cancer follow up with patients. Our lung cancer specialist team provides comprehensive evaluation and treatment options to all patients in need of further assessment. Our team’s multidisciplinary approach ensures that patients with lung abnormalities receive the care they need from the appropriate specialists.

In addition to providing unmatched clinical care throughout the screening and evaluation process, our specialists are making strides in lung cancer screening research. For example, Washington University Physicians are currently participating in the I-STEP (Increasing Screening through Engaging Primary Care Providers) Screening and Nodule Management clinical trial. This joint research study between Washington University School of Medicine and BJC Collaborative focuses on identifying barriers and facilitators to increasing lung screening. The study also investigates the most effective ways to manage different types of lung nodules.

Additionally, several other potential lung screening research opportunities are currently on the horizon.

Advances in screening technology

At Siteman, we use the most advanced technology available to perform screening. Each of our seven screening locations offers a variety of new screening technologies. These may include:

• A 96-row Siemens Somatom Force scanner
• 3-second scan time
• Decreased radiation dose with Sn150 scanner technology
• Increased quality of scan
• SyngoVia Lung CAD program for nodule detection and monitoring

Improved patient outcomes

“It’s encouraging that for those patients who have been screened through Siteman’s lung cancer screening program and were found to have cancer, two-thirds of them have had Stage I disease,” says David Gierada, MD, a Washington University radiologist and a primary investigator of the National Lung Cancer Screening Trial (NLST). “This means we found the cancer early enough that it can’t be detected outside the lung. As a result, the cancer has a high chance of being cured.”

Washington University lung cancer specialists monitor the outcomes of patients who undergo screening as well as the screening practices in our program. This monitoring takes place regionally through the BJC Collaborative and nationally through the American College of Radiology Lung Cancer Screening Registry. Continuous monitoring of screening methods and outcomes ensures that screening is of the highest quality and also identifies potential ways to improve screening practices.

Our screening locations

Siteman offers lung screening at seven locations, with dedicated nurse navigators to assist patients and their healthcare providers throughout the screening and follow-up process. Our nurse navigators are available to answer any questions and to help patients understand their results.

• Anne Stilinovic, RN, BSN, 314-574-1124,for Barnes-Jewish Hospital, Barnes-Jewish West County Hospital and Siteman – South County
• Ellen Brennan, RN, BSN, 636-916-7098,for Barnes-Jewish St. Peters Hospital and Progress West Hospital
• Karmen Fugate, RN, MSN, OCN, 314-653-4529, for Christian Hospital and Northwest Healthcare

To schedule a lung cancer screening, please contact Siteman’s Patient Care Coordination Center at 314-788-3731. If your screening exam detected cancer cells and you wish to schedule a follow-up appointment with a lung cancer specialist at Siteman, please call 800-600-3606.