Inpatient Capture: A Mixed Methods Study to Develop an Inpatient Lung Cancer Screening Program in a Safety Net Hospital.

NCT ID: NCT06876831

Last Updated: 2025-03-14

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 150 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-03-10
• Study Completion Date: 2025-12-31

Brief Summary

Lung cancer continues to be the leading cause of cancer death in the United States. There are several important disparities in lung cancer mortality: racial and ethnic minorities, those with serious mental illness and those with lower socioeconomic status experience higher lung cancer mortality compared to the general population. Lung cancer screening (LCS) with annual low dose chest CT can reduce lung cancer mortality by 20% for high-risk patients, but has been generally underutilized with uptake of 5-15% by eligible patients across the United States. Half of all patients eligible for LCS remain current smokers, and the additional benefits of tobacco cessation services can increase the benefits of LCS clinical encounters in these patients. Despite the proven benefit of LCS and tobacco cessation, it remains out of reach for many with barriers across the patient, provider, and health-care system levels with resultant disparities in uptake of LCS and effective tobacco cessation that may exaggerate disparities in clinical lung cancer early detection and mortality. The majority of LCS care occurs across several visits in an outpatient clinical setting, which may make it inaccessible to the most vulnerable patients.

Our central objective is to extend the reach of lung cancer and tobacco screening through the implementation and evaluation of a program extending these services inpatient in a public hospital that serves a known high-risk and diverse population in East Harlem. Preliminary data obtained from a retrospective quality improvement project examined data from patients admitted over a 3 month period in early 2022. Of 1374 unique patients were admitted to our hospital, 112 patients met LCS eligibility criteria and over 80% had no evidence of having been screened. Forty-seven percent identified as Black and 33.9% as Hispanic, groups known to have worse lung cancer outcomes. While smoking data was incomplete on a majority of patients, 75% of all inpatient admissions were noted to be currently smoking. This, our preliminary data suggest that an inpatient program to provide smoking cessation and LCS in a safety-net hospital may be an effective tool to increase the reach of LCS in a known high-risk demographic and address disparities in LCS and tobacco cessation services.

This proposal represents a prospective pilot study to develop, implement and evaluate an inpatient LCS and tobacco cessation program.

Conditions

Lung Cancer Screening Program

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: SCREENING
• Blinding Strategy: NONE

Study Groups

Meets LCS criteria and former smoker

LDCT on discharge, scheduled date of LDCT, or Lung cancer screening referral

Group Type: EXPERIMENTAL

Shared decision making for LDCT (3 potential outcomes LDCT on discharge, scheduled date of LDCT, or Lung Cancer Screening referral)

Intervention Type: OTHER

These interventions will be facilitated as an inpatient

Meets LCS criteria and active smoker

Inpatient LCS SDM (potential outcomes: 1- LDCT on discharge, 2-scheduled date of LDCT, 3-LCS referral. Along with Inpatient Tobacco Cessation/Reduction Counseling (Handouts, NYC Quits number, medication recommendations to primary team).

Group Type: EXPERIMENTAL

Shared decision making for LDCT (3 potential outcomes LDCT on discharge, scheduled date of LDCT, or Lung Cancer Screening referral)

Intervention Type: OTHER

These interventions will be facilitated as an inpatient

Inpatient Tobacco Cessation Counseling (Handouts, NYC Quits number, Medication Recommendations to primary team, Smoking cessation referral)

Intervention Type: BEHAVIORAL

Active smokers only will received inpatient tobacco cessation counseling/risk reduction

Interventions

Shared decision making for LDCT (3 potential outcomes LDCT on discharge, scheduled date of LDCT, or Lung Cancer Screening referral)

These interventions will be facilitated as an inpatient

Intervention Type: OTHER

Inpatient Tobacco Cessation Counseling (Handouts, NYC Quits number, Medication Recommendations to primary team, Smoking cessation referral)

Active smokers only will received inpatient tobacco cessation counseling/risk reduction

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• 50-80 years of age
• greater than or equal to 20 pack year history
• currently smoking or have quit within the last 15 years

Exclusion Criteria

• < 50 years of age, > 80 years of age
• < 20 pack year history
• quit smoking greater than 15 years

• Minimum Eligible Age: 50 Years
• Maximum Eligible Age: 80 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Fred Hutchinson Cancer Center

OTHER

Sponsor Role: collaborator

Physician Affiliate Group of New York

OTHER

Sponsor Role: lead

Responsible Party

Natoushka Trenard

Attending physician, MD MPH

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Metropolitan Hospital/ NYCHHC

New York, New York, United States

Site Status: RECRUITING

Countries

United States

Central Contacts

Natoushka Trenard, MD, MPH

Role: CONTACT

trenardn@nychhc.org

9548025735

Hyewon Shin, NP

Role: CONTACT

Hyewon.Shin@nychhc.org

7186147558

Facility Contacts

Natoushka Trenard, MD, MPH

Role: primary

trenardn@nychhc.org

9548025735

Hyewon Shin, NP

Role: backup

Hyewon.Shin@nychhc.org

Other Identifiers

23-02-006-182

Identifier Type: -

Identifier Source: org_study_id