WCLC 2025 - Posters & ePosters-P1.17.46 The Best Care One-Lung Program; a Pathway for Lung Cancer Screening in Primary Care

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The Best Care One-Lung program is a pilot lung cancer screening initiative integrated within primary care practices in Hamilton, Ontario, operating from October 2024 to June 2025. Targeting patients aged 55 to 80 with a 20-pack-year smoking history, the program leverages the existing Best Care COPD framework—a Canadian integrated disease management system embedding certified respiratory educator-case managers (CRE-CMs) to support guideline-based COPD care.<br /><br />The program identifies at-risk individuals through electronic medical record (EMR) searches, Best Care COPD data, and primary care physician referral. Invited patients attend a Best Care One-Lung appointment led by CRE-CMs for spirometry (if no COPD diagnosis), calculation of lung cancer risk using the PLCOm2012noRace tool, and shared decision-making. Those with a ≥2% six-year lung cancer risk are referred for annual low-dose CT (LDCT) screening.<br /><br />Among 789 identified individuals, 527 (67%) underwent risk assessment; 66% had COPD. Of these, 352 (67%) had a ≥2% risk and were referred for LDCT screening. The median six-year lung cancer risk in the screened group was 5.7%, with a mean of 7.4% (range 2%-46%). Based on risk profiles, up to 26 early-stage lung cancers are predicted to be detected over six years.<br /><br />This program addresses the challenge of under-identification and referral of high-risk patients in primary care. By integrating lung cancer screening with COPD management, it enhances early diagnosis and treatment pathways, consistent with GOLD guidelines. Best Care COPD currently manages over 10,000 COPD patients across 300 Ontario sites, and plans are underway to expand Best Care One-Lung regionally.<br /><br />Preliminary LDCT results from 97 scans are collected, with ongoing evaluation. This innovative, integrated approach supports PCPs in shared decision-making, improving access to lung cancer screening and potentially reducing mortality in this high-risk population.

Asset Subtitle

Christian Finley

Meta Tag

Speaker Christian Finley

Topic Global Health, Health Services, and Health Economics

Keywords

lung cancer screening

COPD management

Best Care One-Lung program

primary care integration

Hamilton Ontario

PLCOm2012noRace risk tool

low-dose CT (LDCT) screening

shared decision-making

early lung cancer detection

respiratory educator-case managers