Last July, Joe Cruz (his name has been changed) was diagnosed with metastatic lung cancer, which carries a very poor prognosis.\u00a0<\/p>\n
He was not very surprised:\u00a0 he read the labels on cigarettes.\u00a0 Joe has smoked cigarettes for 45 years, since he was 15 years old, averaging one pack per day.\u00a0 In the back of his mind, Joe believed that if he thought too much about the possibility of cancer, it might somehow cause him to develop cancer, so he did not seek medical help when his chronic cough started producing blood-tinged sputum 9 months ago.\u00a0 It wasn\u2019t until he developed right sided hand and arm weakness that Joe sought attention, because he knew that unilateral weakness was a symptom of a stroke and that the key to treating a stroke was to seek out medical help right away.<\/p>\n
The MRI scan of his brain did not show a stroke, but instead showed multiple metastases.\u00a0 A Chest CT confirmed that the likely primary was in his right lung.<\/p>\n
Joe\u2019s story is reflective of a disturbing pattern.\u00a0 In late 2014, the Cancer Committee at NorthBay Medical Center in Fairfield did a study comparing the staging of lung cancer with insurance status, and found that Partnership HealthPlan members are more likely to be diagnoses with stage 4 cancer, compared to those with commercial insurance.\u00a0 They further noted a very low rate of screening for lung cancer using the 2014 U.S. Preventative Services Task Force recommendation:<\/p>\n
\u201cThe USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery.\u201d<\/p>\n
In 2015, Solano County oncologists reached out to major Solano County primary care providers to urge them to talk with smokers about early symptoms of lung cancer and to recommend CT scan screening where appropriate.<\/p>\n
This is not a problem limited to Solano County. A PHC study of lung cancer diagnosis in Shasta county found a similar high rate of very late stage diagnosis.<\/p>\n
The rate of lung cancer in the Medi-Cal population is higher than the state average.\u00a0 The smoking rate among adults with Medi-Cal is roughly double that of the population as a whole.<\/p>\n
In 2015, we found that only 37 patients in all 14 counties had a CT scan to screen for lung cancer, out of an estimated 9000 non-dual eligible smokers between the ages of 55 to 80.\u00a0 We extrapolated smoking rates in the Medi-Cal population to generate this estimate.<\/p>\n
These numbers are very disturbing:\u00a0 our patients smoke more, are diagnosed with Lung Cancer later and are barely being screened at all.\u00a0 Primary care clinicians (and some specialists) are in the best position to have an impact on this, in three ways:<\/p>\n
Partnership Health Plan cannot reliably identify members who use tobacco from the data we have, and the interventions are best done by the health care provider they trust.\u00a0 We are counting on you.\u00a0 Help save lives by making these changes in your practice, this month!<\/p>\n
By Robert Moore, MD MPH, Chief Medical Officer<\/p>\n","protected":false},"excerpt":{"rendered":"
Last July, Joe Cruz (his name has been changed) was diagnosed with metastatic lung cancer, which carries a very poor prognosis.\u00a0<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-1795","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"\n