December 14, 2022
At Temple Health, physicians saw an opportunity for routine lung scans to better support patients’ health, far beyond the lungs.
The program, called the Temple Healthy Chest Initiative, was started last fall in response to a change in U.S. Preventative Services Task Force guidelines that nearly doubled the number of Americans eligible for lung-cancer screenings covered by insurance.
“We knew that lung cancer screening wasn’t being done at the level that it should be in the United States,” said Dr. Gerard Criner, the director of the Temple Lung Center and program founder. “The Healthy Chest Initiative was modeled in part on studies in the United Kingdom and Poland that showed that using low-dose computed tomography scans to screen patients for lung cancer presented a good opportunity to screen them for other conditions at the same time, such as emphysema and heart disease.”
So far, the results have been promising. Since the start of the program just over a year ago, scans have tripled. And, of the people who have received screenings through the Healthy Chest Initiative, there has been a marked increase in populations who need it most—like women and people of color.
The Temple Healthy Chest Initiative also conducts multilingual outreach, offering materials in seven different languages, to help make screenings accessible to—and a priority for—all Philadelphians.
Under the new guidelines, people eligible for screenings include those who:
• Are 50 to 77 years old.
• Currently smoke or have smoked within the past 15 years.
• Have a smoking history number of more than 20 pack years. (Pack years are the number of years smoked multiplied by the average number of packs smoked per day. For example, someone who smoked two packs a day for 10 years would have a smoking history number of 20 pack years.)
The screening covered for people who meet the guidelines is a low-dose computed tomography (LDCT) scan. An LDCT takes multiple images of the chest to create detailed 3D images of organs in the chest cavity with a minimal amount of radiation. The screening requires no preparation from the patient and takes about 10 minutes. To undergo it, patients lie fully clothed on a table that slides in and out of the machine.
Because it scans the entire chest cavity, a LDCT scan can detect other conditions besides lung cancer, including chronic obstructive pulmonary diseases such as emphysema and chronic bronchitis, as well as heart disease and bone problems. The screening also captures images of the heart, spine, stomach and other organs in that area.
“Temple Health designed the Healthy Chest Initiative to take advantage of the low-dose CT scan’s capabilities to diagnose many conditions other than lung cancer,” said Melissa Liverpool, a registered nurse who serves as one of the initiative’s nurse navigators. “If patients are at higher risk for lung cancer due to their age and smoking history, they also are at higher risk for other conditions.”
The Healthy Chest Initiative uses dedicated nurse navigators like Liverpool to support patients through the screening process. These nurses connect with patients before their scans to understand their current health and lifestyle, and provide support and resources, like virtual and in-person support groups, smoking cessation programs and other services that may be beneficial.
Then, once a patient’s scan report is ready, they call and discuss the results and any additional follow-up needed.
“We help communicate results in a way that’s easy to understand while also connecting patients with any other care they need,” Liverpool said. “We also provide realistic recommendations for achieving a healthier lifestyle. This may include dietary changes, exercise programs, and more.”
Nurse navigators send all scans to the patient’s primary care physician and personally schedule any follow-up scans needed.
Even if a patient’s scan doesn’t detect a condition, the nurse navigator will send out a reminder in a year for the person to get another screening, as people at high risk for lung cancer should be screened annually.
“We keep track of each patient’s screenings and remind them when they are due for their next one,” Liverpool said. “We follow them and provide the support they need as they need it.”
That support was very helpful to Teresa Christian, a 55-year-old Fishtown resident who got an LDCT scan from Temple Lung Center for a cold that wouldn’t go away.
Christian said she was nervous about what the scan would find because her mother had been diagnosed with lung cancer at her age and passed away the following year.
“The people I dealt with at Temple were very understanding and knew I was really afraid,” she said. “They walked me through the process, they explained everything, and they put my mind at ease.”
Christian’s initial LDCT scan prompted her doctors to schedule a follow-up scan for her three months later. That scan detected a nodule on her lung that her doctors want to keep an eye on. As a result, she’ll be getting another scan next year.
She has also become an advocate for the Healthy Chest Initiative, having talked to her children, her partner, her partner’s sister and some friends about the importance of getting lung cancer screenings, as well as her positive experience at Temple.
“They’re great,” she said. “It’s relieving to know that Temple is with me on this journey and will be following up with me this time next year.”
Patients who are diagnosed with chest conditions earlier are better able to benefit from treatment plans tailored to fit their particular needs. Healthy Chest Initiative patients have access to the cutting-edge technology, latest clinical trials, and condition-specific support groups available at Temple Lung Center and Fox Chase Cancer Center.
Even if it just focused on lung cancer, the Healthy Chest Initiative would be beneficial.
Lung cancer will be responsible for the deaths of more than 130,000 Americans this year, making it the leading cause of cancer-related deaths in the U.S.
Detecting lung cancer before it spreads outside the lungs is important. Those diagnosed at this early stage have a five-year survival rate of 56%. For people with lung cancer that has spread to other organs, the five-year survival rate is only 5%.
Temple Health is leading efforts nationally to educate other doctors and hospitals to replicate the Healthy Chest Initiative and help more people with early detection of lung cancer and other important medical conditions.
If you fall within the guidelines, getting screened for lung cancer is an easy way to be proactive about your health. When patients are diagnosed with chest conditions earlier, they are able to better benefit from treatment. The Temple Healthy Chest Initiative program can be accessed at all Temple University Hospital campuses and Fox Chase Cancer Center. To schedule an appointment for a lung cancer screening at one of our 5 convenient locations call 800-TEMPLE-MED (800-836-7536).
