Background: Failure to address willingness and ability to undergo lung cancer treatment before lung cancer screening could cause patients unnecessary anxiety, cost, and care. We employed an enhanced shared decision-making (SDM) model to address willingness and ability to undergo lung cancer screening of low-dose CT (LDCT) scanning. We hypothesized that enhanced SDM was feasible and did not discourage patients from undergoing lung cancer screening. Methods: We performed a prospective study of patients referred for lung cancer screening. We measured adherence to the LCS protocol, including consent to discuss lung cancer treatment if cancer is found and direct questions to patients about willingness and ability to undergo lung cancer treatment. We measured race, gender, adherence to the consent process, and questions regarding willingness and ability to undergo lung cancer treatment and subsequent uptake of LDCT. Results: All 190 patients have a documented SDM visit addressing the risks and benefits of lung cancer screening and consented to discuss lung cancer treatment if lung cancer is diagnosed. One hundred and seventy-nine (179) of 190 (94%) answered yes to being willing and able to undergo lung cancer treatment. One hundred and eighty-seven (187) patients underwent LDCT (98.4%). Conclusions: Discussion about willingness and ability to undergo lung cancer treatment should be an essential component of an SDM discussion prior to LDCT. This study demonstrated that an enhanced SDM experience is feasible in a clinical setting. Furthermore, patients proceeded with LDCT following the enhanced SDM process. Citation Format: Cherie P. Erkmen, Mark Mitchell, Simran Randhawa, Shelby Sferra, Rachel Kim, Verdi DiSesa, Larry R. Kaiser, Grace X. Ma. An enhanced shared decision-making model to address willingness and ability to undergo lung cancer screening and follow-Up treatment [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr A18.

SESSION TITLE: Late-Breaking Abstracts 1 SESSION TYPE: Late-Breaking Abstract Slide PRESENTED ON: Tuesday, October 31, 2017 at 02:45 PM - 04:15 PM PURPOSE: Several trials have demonstrated that early detection of lung cancer with low dose CT scan (LDCT) has improved mortality, but none have focused on an African American population. This population has a higher rate of smoking, of lung cancer, and death from lung cancer than the general population. We hypothesize that successful implementation of lung cancer screening with LDCT will lead to early detection and treatment of lung cancer in African Americans. METHODS: We performed a prospective study of African American patients who were referred to our lung cancer screening program at an urban, academic medical center who were undergoing a single-visit experience for lung cancer screening. We closely examined the demographics of this patient population, and measured rates of lung cancer detection in this population, Lung-RADS scores, and complications of interventions. Between October 1, 2015 and January 3, 2017, 217 patients were referred and entered into the study. RESULTS: Of 217 African Americans undergoing lung cancer screening, 56.7% were women. Average age was 63.7 (SD 5.81). 31.8% had not graduated from high school, 34.1% had a high school degree, 29% had advanced education and 5% declined to answer. Average pack years were 46.6 (SD 17.23; range 30-120). 67.2% were current smokers. Participants had other risk factors including 18.4% with family history, 6.9% with environmental exposure and 41.9% with second hand smoke exposure. LDCT results were 0.5% Lung-RADs 0; 44.2% Lung-RADs 1; 45.1% Lung-RADs 2; 4.1% Lung-RADs 3; 6% Lung-RADs 4. Seven (3.2%) patients received biopsy (3 CT guided, 2 transbronchial, 2 surgical). Three (1.4%) were diagnosed with stage 1 lung cancer and received surgery (2) or radiation therapy (1). One with stage IV lung cancer received chemotherapy. There were no complications from biopsy or treatment. CONCLUSIONS: Implementation of lung cancer screening in an African American population found that 10.1% of patients received a Lung-RADs 3 or 4 report, 3.2% received invasive biopsy and 1.4% were diagnosed with early lung cancer. Our study demonstrates successful implementation of lung cancer screening in an African American population. Long-term follow up will be needed to understand the impact of lung cancer screening on survival. CLINICAL IMPLICATIONS: This study demonstrates that lung cancer screening can not only be successfully implemented in an underserved African American population, but that it can lead to early detection and treatment of lung cancer. No Product/Research Disclosure Information

Failure to address willingness and ability to undergo lung cancer treatment before lung cancer screening could cause patients unnecessary anxiety, cost and care. We employed an enhanced shared decision making (SDM) model to address willingness and ability to undergo lung cancer screening of low dose CT (LDCT) scanning. We hypothesized that enhanced SDM was feasible and did not discourage patients from undergoing lung cancer screening. We performed a prospective study of patients referred for lung cancer screening. We measured adherence to the LCS protocol, including consent to discuss lung cancer treatment if cancer is found and direct questions to patients about willingness and ability to undergo lung cancer treatment. We measured race, gender, adherence to the consent process and questions regarding willingness and ability to undergo lung cancer treatment and subsequent uptake of LDCT. All 190 patients have a documented SDM visit addressing the risks and benefits of lung cancer screening and consented to discuss lung cancer treatment if lung cancer is diagnosed. One hundred and seventy-nine (179) of 190 (94%) answered yes to being willing and able to undergo lung cancer treatment. One hundred and eighty-seven (187) patients underwent LDCT (98.4%). Discussion about willingness and ability to undergo lung cancer treatment should be an essential component of a SDM discussion prior to LDCT. This study demonstrated that an enhanced SDM experience is feasible in a clinical setting. Furthermore, patients proceeded with LDCT following the enhanced SDM process.