Grant: Project Grant

Background: Quebec is implementing a provincial lung cancer screening program which will screen 3,000 high risk smokers between 55-74 years of age with two annual low dose CTs over two years. The three main causes of death in participants screened for LC are cardiovascular disease (CVD 25%), LC (24%), or chronic obstructive pulmonary disease (COPD, 10%). Participants enrolled in lung cancer screening have been shown to have high rates of untreated cardiovascular disease, identified on imaging of the heart on low dose CT of the chest, and untreated COPD, identified on imaging and history documented by lung cancer screening navigators. Methods: We will perform a randomized clinical trial of comprehensive personalized health intervention provided to physicians and patients. Exploiting data already extracted by nurse navigators for lung cancer screening, and data from imaging by low dose CT as part of clinical care, we will implement a clinical decision support for primary care providers, and educational resources for patients. This will empower patients and their providers to engage with proven effective treatments for cardiovascular disease and COPD. Primary outcomes, determined at one year, are guideline concordant statin therapy in participants with moderate to severe coronary calcifications (objective 1), and guideline concordant inhaler therapy in symptomatic COPD (objective 2). Conclusions: If our hypotheses are confirmed, this patient-centered low cost approach will prove effective in mitigating health disparities among high risk men and women who have shown significant barriers in access to evidence-based care. It will also provide added value to lung cancer screening programs at low cost.