Hi, I'm Jennifer King from the GoTo Foundation for Lung Cancer, and today I'm presenting the abstract, The Impact of the COVID-19 Pandemic on Lung Cancer Screening Programs in the United States. These are my disclosures. The GoTo Foundation for Lung Cancer has a Centers of Excellence program, where we work with hospitals, both academic and community, to ensure high-quality lung cancer screening, as well as referral patterns to multidisciplinary care. Every year, we do a survey to gather data from all of the centers on what's happening with lung cancer screening and to assess practice patterns. In our survey that was fielded between July and September of 2020, we had a response rate of 33.5% when you look at lung cancer screening programs, but that actually represents 56.5% of distinct screening sites within the network. The map on the right hand of the slide shows the distribution of centers and where most centers are the main primary site of most of these programs. This very much mirrors where people are being screened across the United States. These centers that responded to the survey represent over 125,000 unique patients screened in 2019, with a median of 790 patients screened per program. As I mentioned, program respondents could be from either single-site or multi-site centers, so this data represents 423 unique screening sites across the United States. There's a difference in the practice settings. We see both academic and community, with community sites making up the large majority of those who responded to the survey and who are seeing these patients on an everyday basis. What we found was that screening programs experienced major disruptions due to COVID-19. 85% of the programs were on hiatus at some point during the COVID-19 pandemic. The duration of the hiatus varied, but more than three quarters of the programs reported at least a 5-10 week hiatus, and multiple programs reported much longer stoppage of screening, such as 11-15 or 16-20 weeks. In one case, there was one single screening program who was still on hiatus at this time. In addition, even though most centers had returned from their hiatus, there was a significant decrease in patient screening volume. Centers were asked to compare their current screening volume during the pandemic to their pre-COVID-19 levels, and what we saw was the majority of centers reported both a decrease in screening volume in new patients, as well as in existing patients who were returning for their annual scans. Notably, the decrease of new patients was even higher, with more centers, 36%, reporting a significant decrease during the pandemic compared to pre-pandemic levels. The good news is that the capacity of the screening programs from a programmatic and an infrastructure level had returned by the time of the survey. In addition, these programs were doing more incorporation of telemedicine, with half of them now incorporating shared decision-making through telemedicine, and 44% incorporating their smoking cessation activities through telemedicine. Unfortunately, still a lot of challenges remain for the programs. What we found was that patient-based challenges came to the top of the list. Most programs were predominantly concerned by what patients felt, whether they felt safe returning to the healthcare facility. They viewed this as the most significant challenge in actually attracting patients to come back. In addition, second was increased financial barriers for patients, and just the general difficulty of reengaging with patients came in third. After that, there were a number of other challenges at a lower rate that were also ongoing. The take-home messages are that the COVID-19 pandemic did significantly affect lung cancer screening programs, and most required a hiatus of five or more weeks. Screening programs reported notable decreases in patient volume, and they're still facing patient-related barriers that are preventing them from getting to their pre-COVID-19 screening volumes. Previously published data from this network had demonstrated that lung cancer screening within this network produced a significant stage shift to almost half stage one diagnoses. Therefore, reduction in screening volumes is likely to result in more late-stage lung cancer diagnoses as we move past the pandemic or into new phases of this pandemic. This is an area that the entire lung cancer community needs to watch and take seriously as we may be seeing an influx of late-stage patients. Thank you very much for your attention.

COVID-19 pandemic

lung cancer screening programs

disruptions

patient screening volume

patient-based challenges