Read time: 4 minutes.
Lung cancer screening has the potential to save more lives than any other cancer screening tool, yet reports suggest only 10%–20% of eligible patients are screened each year.
For veterans, who are at increased risk of developing lung cancer, annual screening is a key health and wellness opportunity. According to the US Department of Veterans Affairs (VA) website, lung cancer is the leading cause of cancer-related death among veterans. To address this clear need, the VA implemented a Lung Cancer Screening Program to encourage eligible veterans to get no-cost lung cancer screenings. Nevertheless, uptake of these lifesaving services remains low.
To increase the adoption of screening in veteran populations, Neelima Navuluri, MD, MPH, a physician-scientist at Duke University School of Medicine and the Durham Veterans Affairs Healthcare System, was awarded one of LUNGevity’s 2023 VA Scholar Research Awards.
LUNGevity sat down with Dr. Navuluri to discuss why supporting lung cancer screening is vital and how innovative tools could transform patient decision-making.
LUNGevity Foundation: Why is it important to increase lung cancer screening?
Dr. Neelima Navuluri: Most people don’t know this: Lung cancer screening is unique among cancer screenings because it has been shown to saves lives overall, not just from cancer. While mammograms reduce breast cancer mortality and colonoscopies reduce colon cancer mortality, large lung cancer screening trials in the US demonstrated a reduction in all-cause mortality. That means people who were screened regularly for lung cancer lived longer. This was primarily because fewer people died from lung cancer, but also potentially because early detection and monitoring may have reduced deaths from other causes as well.
This robust data helped demonstrate the value of lung cancer screening and establish screening guidelines. But lung cancer screening uptake still lags far behind breast and colon cancer screening rates. Closing that gap is both a strategic and a lifesaving opportunity.
LF: How did you get interested in lung cancer screening?
NN: During my pulmonary fellowship in North Carolina, I noticed many of my African American patients were being diagnosed with late-stage lung cancer and that did not necessarily seem to be the case among my White patients. That pattern of inequity deeply concerned me.
Knowing my concerns, a colleague invited me to analyze a large database of electronic medical records at the Durham Veterans Affairs Medical Center to investigate lung cancer screening disparities. We found clear racial differences in screening and outcomes between Black and White veterans. From there, we conducted qualitative research to hear directly from veterans about their experiences, as well as barriers and motivations around screening. That work became the foundation for my LUNGevity project.
LF: Tell us about your research project.
NN:. Our research showed many barriers to lung cancer screening exist, including fear of cancer diagnosis, patient mistrust, structural racism, and providers thinking that lung cancer screening wasn’t a top priority and not having time to do high-quality shared decision making. My project focuses on addressing many of the barriers to lung cancer screening by developing a personalized electronic tool for veterans.
We are creating a tool to put clear, relevant information at their fingertips. By incorporating their unique risk factors and preferences, we are hoping to help veterans make informed healthcare decisions.
It’s designed for use within the VA, but it also has the potential to be adapted for other populations. By meeting patients where they are, and tailoring the information to them, we can empower them to take action and prioritize getting screened for lung cancer.
LF: What does success look like for this project?
NN: Success means increasing screening rates equitably across the VA. Specifically, that means we implement a tool that helps historically underserved groups, such as African American men, who are known to face higher risks of lung cancer and worse outcomes. Ultimately, we want more patients to be diagnosed at stage 1 or even 2, when treatment is more effective and sometimes even curative. That stage shift could change the trajectory of lung cancer outcomes and care.
LF: Why should the lung cancer community be excited about this work?
NN: Because it’s about changing the default. Instead of diagnosing most lung cancers at stage III or IV, where treatment options are not curative, we’re creating ways to catch it early. That’s transformative. And we’re doing it by empowering people who are at the highest risk to make informed, lifesaving decisions.
LF: How has this research award impacted your career?
NN: I’m so grateful for this award. It gave me resources to bring together a skilled team and pursue solutions that matter. Through this award, I’ve strengthened my scientific skillsets and I’m now well-positioned to contribute to lung cancer research in an even more meaningful way.
LF: What would you say to someone considering donating to research?
NN: Lung cancer remains the leading cause of cancer death in the U.S. It claims more lives than breast, colon, and prostate cancers combined. There is enormous need for innovation and investment in lung cancer prevention, early detection and treatment. Every dollar directed to LUNGevity’s research programs has the potential for outsized impact in transforming lung cancer into a detectable and curable disease.
Donate today to support research projects that are transforming lung cancer.