Innovative Clinical Pathways in Lung Cancer Care for Vulnerable Populations

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DESCRIPTION (provided by applicant): Lung cancer is the leading cause of cancer death in the world and kills three times as many Americans as any other form of cancer. 1, 2 The five-year survival rate for all patients in whom lung cancer is diagnosed is approximately 15 percent, much lower than the 64 percent for colon cancer, 89 percent for breast cancer and 99 percent for prostate cancer.3 For certain vulnerable populations, lung cancer incidence, prevalence and mortality rates are significantly higher when compared to the general population.4 Research has shown that many diseases, including lung cancer, are caused by differences in access to and quality of care.5 Health disparities in lung cancer care are multifactorial and include access to care, cultural differences, communication issues with providers leading to refusal of care, biologic differences, and the systemic and structural impacts of race and class.6 In addition, studies indicate that disparities exist even in an equal access system, and throughout all areas of the cancer spectrum spanning screening, diagnosis, treatments, as well as survivorship and end of life care1-6. Both the Institute of Medicine Report Unequal Treatment, and individual studies show that disparities exist even in equal access systems like Medicare. 7-11 Given the importance of addressing disparities in lung cancer rates across vulnerable populations, the Division of Women's Health at the Brigham and Women's Hospital seeks a small conference grant to support a joint- initiative with the Dana Farber Cancer Institute (DFCI) entitled Innovative Clinical Pathways in Lung Cancer Care for Vulnerable Populations. This is a two-day stakeholder dissemination and implementation conference. The invitation-only conference will be held at Brigham and Women's Hospital in Boston, Massachusetts in the winter of 2012. The goal of the conference is to design innovative pathways along the full spectrum of lung cancer care that address factors contributing to health disparities in vulnerable populations. The full spectrum of lung cancer care will include risk assessment, detection, diagnosis, and treatment of non-small cell lung cancer (NSCLC), the most common type of lung cancer.7 Design of the innovative pathways to NSCLC care will be informed by an examination of the many factors that influence health disparities, including access to care, cultural differences, communication issues,, biologic differences, and the systemic and structural impacts of race and class including poverty and social injustice.8, 9 Conference attendees will also design a pilot study to test the efficacy of the proposed pathways in providing NSCLC care across vulnerable populations. PUBLIC HEALTH RELEVANCE: Program Director/Principal Investigator (Last, First, Middle): Colson, Yolanda Narrative Lung cancer is the leading cause of cancer death in the world and kills three times as many Americans as any other form of cancer. For certain vulnerable populations, lung cancer incidence, prevalence and mortality rates are significantly higher when compared to the general population. This conference brings together stakeholders to design innovative pathways along the full spectrum of lung cancer care to address factors contributing to these health disparities and to design a pilot study to test the efficacy of the proposed pathways.