Hunter Holmes McGuire VA Medical Center - Richmond, VA
Richmond VA now Center of Excellence
Central Virginia VA Health Care System (CVHCS) is currently the only VA in the country to be designated as a Screening Center of Excellence by the GO2 Foundation for Lung Cancer for its ongoing commitment to effective lung cancer screening (LCS). Lung cancer is the leading cause of cancer deaths in both men and women among the general population.
The health care system uses low dose computed tomography (LDCT), which screens for cancer in its early stages and helps to save Veteran lives.
“The population of Veterans in which we serve are at a very high-risk of developing lung cancer,” says Dr. Peter Lee, the Director of Interventional Pulmonology at CVHCS. “Lung cancer screening is the most effective tool in reducing cancer-related deaths among this population.”
CVHCS currently performs lung cancer screenings for approximately 12% of its eligible high-risk Veteran population. Lee says that is three times higher than the nation.
“Nearly 40% of our enrolled screening population are black Veterans and of those 69% are active smokers,” said Lee. “Many live in rural and inner-city settings where unrecognized social determinants of health may adversely impact access to preventive care.”
Up until the past decade, there was no way to identify lung cancer at an early stage. But now, LDCT screening for lung cancer carried out safely, efficiently and equitably can save tens of thousands of lives a year by finding lung cancer early when it is most treatable and curable.
The CVHCS LCS Program opened in 2017. In the program’s first two years, the team enrolled 1,182 Veterans and continue to add approximately 600 Veterans annually. Between 2017 and 2019, LDCT diagnosed 16 new lung cancers. Of these cancers, 62% were stage I or stage II. When diagnosed early, Veterans can achieve five-year survival rates of up to 92%.
To give perspective, two-thirds of the nation’s lung cancer diagnoses are discovered at advanced stages. Without early detection, the chances of survival within five years of diagnosis can be as low as 16%.
The LCS team at CVHCS consists of two nurse navigators, Kelly Szerenyi, a nurse practitioner and Robin Willingham a registered nurse, and two pulmonologists, Dr. Peter Lee and Dr. Howard Li. The comprehensive screening program provides education on early lung cancer detection, tobacco cessation counseling, abnormal lung nodule management and maintenance of an LCS registry. The program is an integral part of the CVHCS multidisciplinary Thoracic Tumor Board, which provides high-quality diagnosis and management of thoracic malignancies to Veterans.
Maintaining the SCOD designation
To maintain this Center of Excellence status, the team plans to raise lung cancer awareness among high-risk Veterans and continue to advocate for lung cancer screening across all sites of care. As they improve their methods of screening to address healthcare disparities among high-risk Veterans, they will incorporate new technologies and evidence-based strategies. The future success of the program will rely on an effective LCS registry. The registry will assist in exploring new screening outcomes of high-risk, under-served Veterans and help develop opportunities for precision oncology.