Episode 359: Lung Cancer Screening, Early Detection, and Disparities

“I was actually speaking to a primary care audience back a few weeks ago, and we were talking about lung cancer screening. And they said, ‘Our patients, they don’t want to do it.’ And I said, ‘Do you remind them that lung cancer is curable?’ Because everybody thinks it is a death sentence. But when you’re talking about screening a patient, I think it’s really important to say, ‘Listen, if we find this early, stage I or stage II, our chances of curing this and it never coming back again is upwards of 60% to 70%,’” ONS member Beth Sandy, MSN, CRNP, thoracic medical oncology nurse practitioner at the Abramson Cancer Center at the University of Pennsylvania in Philadelphia, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about lung cancer screening.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by April 18, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to lung cancer screening.

Episode Notes 

• Complete this evaluation for free NCPD. 
• ONS Podcast™ episodes:
• Episode 313: Cancer Symptom Management Basics: Other Pulmonary Complications
• Episode 295: Cancer Symptom Management Basics: Pulmonary Embolism, Pneumonitis, and Pleural Effusion
• Episode 247: Tobacco Treatment for Patients With Cancer
• ONS Voice articles:
• Lung Cancer Screening and Early Detection Drastically Improves Survival Rates
• Pack-Year History Is a Biased and Inadequate Criterion for Lung Cancer Screening Eligibility, Researchers Say
• CMS Expands Eligibility Criteria for Lung Cancer Screening With Low-Dose Computed Tomography
• Non-Small Cell Lung Cancer Prevention, Screening, Diagnosis, Treatment, Side Effects, and Survivorship
• Clinical Journal of Oncology Nursing articles:
• Nurse-Led Tobacco Cessation for Veterans Using Motivational Interviewing in a Lung Cancer Screening Program
• Identifying Primary Care Patients at High Risk for Lung Cancer: A Quality Improvement Study
• Oncology Nursing Forum article: Patient–Provider Discussion About Lung Cancer Screening Is Related to Smoking Quit Attempts in Smokers
• ONS Tobacco, E-Cigarettes, and Vaping Learning Library
• American Cancer Society Lung Cancer Screening Guidelines
• American Lung Association lung cancer resources

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From This Episode

“Unfortunately, the current state of lung cancer screening is pretty low. Our rate of uptake in eligible patients is somewhere between 6% and 20%. And that falls much further below what we see for screening, such as breast cancer screening, prostate cancer screening, and colorectal cancer screening. So certainly, we can do better.” TS 1:32

“If you quit more than 15 or 20 years, your risk of developing lung cancer at that point is significantly lower. And so that’s why once patients have quit more than 15 years, they’re actually not eligible for screening anymore—because their risk of developing lung cancer is dramatically reduced. And that takes into account when you are a primary care provider, pulmonary, whatever field you work in, and you are running a screening clinic each year that you screen the patient, you have to remind yourself when they quit smoking, because once they reach that 15 years, then they’re no longer eligible for screening.” TS 5:17

“One of the strategies that they’ve used to get the word out is, I watch a lot of baseball. I love the Philadelphia Phillies, watch Phillies games. And so at least once a year, maybe even twice a year, they will take an inning of the baseball broadcast on TV and on the radio separately, and they will bring on either an oncologist or pulmonologist from one of the local cancer centers in our area, and the whole inning—between batters of course—they will talk about lung cancer screening and why it’s beneficial.” TS 13:16

“Medicare always has its idiosyncrasies. So Medicare—I went over the rules with you, so the age, the smoking. They follow all of it, except they have a slight difference in age. They cover it for age 50 to 77, as opposed to 80.” TS 16:52

“I think just the other thing that people don't think about is that to go get a medical test done, no matter what test it is, typically people have to take time off of work. And it can be really hard to do that when you are relying on your job, maybe you don't have vacation time, maybe you have children at home that you need to get home to. When people are weighing the risk/benefit and thinking, ‘Well, I’d love to get screened for lung cancer, but I just can’t find time to fit it into my schedule, and my job won’t let me take off.’ These are all things that we don’t always think about if you have the luxury of just taking the day off.” TS 20:01