Approximately 240,000 people are diagnosed with lung cancer each year in the U.S., with only 16% diagnosed in Stage 1, the earliest, most treatable stage. For over a decade, Kaiser Permanente has been systematically working to improve lung cancer screening for eligible patients and is seeing positive results. At Kaiser Permanente, nearly 40% of patients with lung cancer are diagnosed at Stage 1, meaning Kaiser Permanente patients are less likely to die from this devastating disease.
“Kaiser Permanente patients have a 50% lower mortality rate from lung cancer, compared to the rest of the nation and are more likely to have their cancer found at Stage 1,” said Luis Ruiz, MD, Chief of Pulmonary Medicine at Kaiser Permanente. “Kaiser Permanente’s commitment to screening and treating lung cancer means our patients live longer, healthier lives.”
Routine lung cancer screening is recommended for certain patients with a history of smoking, but, unfortunately, uptake of this option has been slow across the U.S. Recognizing that lung cancer is the most common cause of cancer-related death in the country, Kaiser Permanente built robust systems to ensure the right patients get screened at the right time. In fact, Kaiser Permanente screens five times more patients than the national average.
“We developed systems to ensure we know a patient’s smoking history because smoking is the leading cause of lung cancer,” Dr. Ruiz said. “Accurate documented smoking history allows us to remind and encourage patients to complete recommended cancer screening. Knowing smoking history enables us to determine who is at high risk for lung cancer so we can talk with that patient about the importance of low-dose CT scans for screening. This is critical because early detection saves lives. People can survive lung cancer.”
Kaiser Permanente patient Sharon Ross, whose Stage 1 lung cancer was detected on a low-dose screening CT scan, benefited from Kaiser Permanente’s patient-centered system. Aware of her smoking history, her Kaiser Permanente physician recommended she get screened; the test detected a cancerous lesion on her left lung. She has been treated successfully by her doctors at Kaiser Permanente and now is using her voice to encourage other eligible smokers and former smokers to get tested.
“Take the screening,” Sharon says. “I used to be afraid of what’s going on in my body. I’m not anymore. I am so thankful.”
Low-Dose CT Screening Saves Lives
At Kaiser Permanente, our physicians collect and record smoking history in our integrated electronic medical record, providing our doctors the information they need to:
• Determine who is at-risk for lung cancer
• Recommend screening with a low-dose CT scan, and
• Catch cancer earlier in more treatable stages
Screening with a non-invasive low-dose CT scan of the chest increases the likelihood of detecting the cancer in its earliest stages – when the tumor is small and before the cancer has spread – which offers the best chance for successful treatment and long-term survival. If diagnosed once the cancer has spread to distant parts of the body, the five-year survival rate is as low as 9%.
More Kaiser Permanente patients are diagnosed with lung cancer at Stage 1 than the national average because Kaiser Permanente has pioneered new ways to make lung cancer screening easier and more comprehensive. On the Kaiser Permanente portal, patients can complete pre-appointment questionnaires that ask about smoking history. Patients also are asked about their smoking history during medical visits. Using that information, Kaiser Permanente implements alerts in patients’ electronic medical records so that primary care physicians and medical specialists are notified if a patient is eligible for a lung cancer screening.
Sharon is one of many Kaiser Permanente patients who benefited from our novel approach.
Saved by the Scan
“The scan definitely caught the cancer,” said Amy Gills, MD, regional medical director for Radiation Oncology at Kaiser Permanente. “We fortunately have systems in place across Kaiser Permanente to enable doctors to know a patient’s smoking history so that we can screen the right patients at the right time. If everyone screened patients for lung cancer at the same rate we do at Kaiser Permanente, approximately 960 lives would be saved every year.”
Sharon is proof of that.
“I pray that people will be as lucky as I was,” Sharon says. “I have had and still have wonderful doctors at Kaiser Permanente. Had my doctor not suggested I take the screening, I might not be here today. I am feeling good. I’m back.”
Treatment in Kaiser Permanente’s Integrated Health System
Kaiser Permanente is one of the only health systems in the Mid-Atlantic with in-house next generation sequencing (NGS). All high stage lung cancer cases, where cancer has spread, receive genetic tumor sequencing. Genetic sequencing results provide valuable information to prescribe personalized tumor-specific treatments to target a patient’s specific cancer. Since this genomic testing is done in Kaiser Permanente’s local laboratory, results are quickly available (in just a few days), so oncologists rapidly have the information needed to prescribe the most effective treatment.
“Our patients facing cancer are incredibly lucky to have access to a multidisciplinary team and personalized medicine,” says Dr. Gillis. “Outside of Kaiser Permanente, it can take weeks or even months to consult all the specialists involved in treating a patient with cancer and NGS results are typically not available for weeks, delaying critical treatment decisions.”
Since 2018, Kaiser Permanente Mid-Atlantic States Cancer Program has been Accredited with Commendation from the Commission on Cancer (CoC), a quality program of the American College of Surgeons in 2022. The Commission on Cancer awards this voluntary designation to cancer programs that meet 34 quality care standards and maintain levels of excellence in the delivery of comprehensive patient-centered care.
About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and nonprofit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 12.5 million members in 8 states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists, and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery, and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education, and the support of community health. For more information, go to about.kp.org.
