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For this Assignment you will pick one recommended screening from United States Preventive Task Force A and B Recommendations. An initiative is a project, an event, so something in the community is ideal. Workplace location for employees is fine too. Please include the following suggested level one headings so content is clear and easily identified.Theory or Conceptual ModelChoose a theory or conceptual model that you think might work for your initiative and explain the theory or model here. You may choose to independently research your model to help you explain its application to your initiative. If you have found another model you will like to use, not listed, contact your instructor.Screening PurposeDiscuss why it is important to screen for this condition. This is where you address your community assessment and the reason for this need in your community/ population choice. Support your stance with statistics and information, ideally related to the location and population.PopulationClearly address the demographics that are being screened; where they live, state, county, ages, races included etc.Screening ActivityThis section is what you are doing at the screening and should completely align with the screening guideline for the condition. Also all health promotion screenings include some brief prevention education component. Outcome GoalsBullet a few specific goals here. What do you hope to accomplish with your screening?LocationBriefly explain where you are doing this. It should be very specific (e.g., Senior Citizen Center in Monroe Co on Saturday). Think about what kind of facility or area you will need. Include comments explaining how this location meets the needs of your target population and screening choice.CostThis is the cost for you to develop and conduct the initiative. It is best displayed as a brief Word table showing what it costs you to conduct the screening; paper, equipment, rental s etc. Volunteers are fine, but everything is not free. Students must demonstrate they can develop a cost estimate for a community screening intervention that is realistic and takes into account financials. If there is a cost for the attendees that should go here as well.SummaryProvide a summary of your screening, general benefit to the community and why it is important. Master’s-prepared nurse educators, leaders, nurse practitioners and all specialty nursing fields are contributors to health promotion in populations across the life span. This Assignment is focused on preventive screening applications in the community, workplace or school settings. You should be able to apply this knowledge to their specialty focus as it relates to health promotion and epidemiology.This should be a 3-4 page paper, excluding title page, and references. A person should be able to read your paper and understand fully what you are screening, where, when, the costs and how it is supported in the guideline. Ideally a person would be able to duplicate your screening initiative, based on the clarity you present. This paper should adhere to appropriate 6th edition APA format. A minimum of 3-4 sources should be used.
mn505__guideline_of_screening_for_lung_cancer.docx
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Running head: SCREENING FOR LUNG CANCER
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Screening for Lung Cancer
Maria Arbolay
MN505
Running head: SCREENING FOR LUNG CANCER
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Screening for Lung Cancer
Lung cancer is a cancer that forms in tissues of the lung, typically in the cells lining air
passages. It has been classified in two main types: non-small cell lung cancer (NSCLC) and
small cell lung cancer (SCLC). About 85\% of all lung cancers are known as non-small cell and
about 75\% of these are metastatic or advanced, at diagnosis. Lung cancer occurs in numerous
kinds of cells in the lung. As well as other cancers, lung cancer occurs when abnormal cells grow
out of control. These cells can form a tumor or spread to other parts of the body (U.S. Preventive
Services Task Force, 2013).
Lung cancer is the leading cause of cancer death in the United States. Though; the most
common type is non-small cell lung cancer that occasionally can be cured is it is found early.
Treatment includes surgery to remove the part of the lung that has cancer. Unfortunately, about
90\% of the people who have lung cancer die from the disease, because it is not found until the
cancer is at an advanced stage (U.S. Preventive Services Task Force, 2013).
About 85\% of lung cancers are caused by smoking. The risk of developing lung cancer
increases with the amount a person smokes and the length of time a person smokes. Also, the
risk of lung cancer increases as people get older. Assessment of smoking and the providing of
smoking cessation services should be part of any lung cancer screening program American Lung
Association, 2015). Most of lung cancers happen in people 55 years old and older. The most
significant way to decrease the risk of developing lung cancer is to not smoke or stop smoking
and avoid contact to tobacco smoke (National Guideline Clearinghouse, 2016).
The population of concern for this screening is asymptomatic adults aged 18 years old
and older who are at average or high risk but are not suspect of having lung cancer. The
Running head: SCREENING FOR LUNG CANCER
3
population includes present, former, and second-hand smoker, as well as those with exposures to
elements that may affect risk and other identified factors that may increase risk (National
Guideline Clearinghouse, 2017). The recommendations from this guideline don’t apply to
individuals with previous lung cancer or sign and symptoms of lung cancer. The purpose of this
screening guideline is to provide preventive care to increases the chances to detect certain
cancers early.
The screening interventions of interest included: chest radiography (CXR), low-dose
tomography (CT), and sputum cytology (SC). Also, only RCTs with comparison groups of no
screening or comparison between tests were eligible for inclusion; however, case control, case
series, and ecological studies were omitted. Any quantitative study design (with or without
comparison groups) was considered adequate to answer the key question about harms of
screening.
The benefits of the screening are describe through the systematic review where the task
force included 33 studies on lung cancer screening; 13 randomized controlled trials (RCTs).
Seven low-quality studies evaluated screening with chest radiography (with or without sputum
cytology), compared with no screening or less intensive screening (e.g., screening with chest
radiography at longer intervals or instruction to have a chest radiography) and found small
benefits in terms of early disease detection. Screening with chest radiography detected more
early-stage and fewer late-stage lung cancers compared with groups receiving usual care.
However; such screening did not reduce lung cancer specific mortality (risk ratio (RR) 0.99\%,
95\% confidence interval (CI) 0.92-1.07) or all-cause mortality (RR 0.98\%, 95\% CI 0.96\%-1.00)
when compared with usual care (National Guideline Clearinghouse, 2017).
Running head: SCREENING FOR LUNG CANCER
4
Three low-quality trials compared annual screening with low-dose computed tomography
(CT) to no screening or usual care found no differences in lung cancer-specific mortality (RR
1.30\%, 95\% CI 0.81-2.11) or all-cause mortality (RR 1.38\%, 95\% CI 0.86-2.22) after five years
or less of follow-up. The National Lung Screening Trial (a high-quality RCT) reported a 15\%
reduction in lung cancer mortality (RR 0.85, 95\% CI 0.75-0.96) and a 6\% reduction in all-cause
mortality (RR 0.94, 95\% CI 0.88-1.00) associated with screening with low-dose CT compared
with chest radiography after 6.5 years of follow-up. This means that screening 1000 people with
low-dose CT three times at one-year intervals prevents three deaths from lung cancer compared
with screening of a chest radiography (number needed to screen = 322) (National Guideline
Clearinghouse, 2017). The Task Force found that low-dose CT scans more accurately identify
early stage cancer than do other screening tests (U.S. Preventive Services Task Force, 2013).
The Task Force also found that lung cancer screening has some harms. The test can
recommended that a person has lung cancer when, in fact, no cancer is present. This is called
false-positive result which can cause concern and anxiety and it can lead to follow-up tests and
surgeries that aren’t needed and that may have their own significant risks. Also, people receiving
radiation during low-dose CT scan could be harmful for them because radiation from repeated
scans can cause cancer in otherwise healthy people (National Clearing House, 2016). Also, harm
is the overdiagnosis, it happens when people who are symptomatic undergo screening for lung
cancer and slow-growing cancer that would have never caused them any harm during their
lifetime is noticed and diagnosed. Overdiagnosis frequently leads to unnecessary treatment that
can cause harm.
In conclusion, annual screening for lung cancer with low-dose computed tomography is
of reasonable clear benefit in asymptomatic persons who are at high risk for lung cancer based
Running head: SCREENING FOR LUNG CANCER
on age, total cumulative exposure to tobacco smoke, and years since quitting smoking (U.S.
Preventive Services Task Force, 2013). National-Level quality is currently being established by
Pan-Canadian Lung Cancer Screening Network. Other recommend performance measures,
though problematic to measure, include rates of discussion of screening for lung cancer using
low-dose CT among populations at high risk and the quantity of potentially eligible adults
receiving correct information about the risks and benefits of screening (ideally using evidencebased decision assistance). Reduction in use of chest radiography to screen for lung cancer is a
potentially significant implementation measure. Harms of screening and follow-up tests in
different settings should also be continually measured. Incidence and mortality statistics related
to lung cancer should continue to be monitored at national and territorial levels (National
Guideline Clearinghouse, 2017).
5
Running head: SCREENING FOR LUNG CANCER
6
References
American Lung Association. (2015). Lung force: Providing guidance on lung cancer screening to
patients & physicians. Retrieved from www.lung.org/assets/documents/lung-cancer/lungcancer-screening-report.pdf
National Guideline Clearinghouse. (2016). Recommendations on screening for lung cancer.
Retrieved from https://elbiruniblogspotcom.blogspot.com/2016/08/recomendations-onscreening-for-lung.html
National Guideline Clearinghouse. (2017). Recommendations on screening for lung cancer.
Retrieved from https://www.guidelines.gov/summaries/summary/50141/recomendationson-screening-for-lung-cancer?q=lung+cancer
U.S. Preventive Services Task Force. (2013). Understanding task force recommendations:
Screening for lung cancer. Retrieved from
file://C:/Users/Admon/Downloads/lungcanfact.pdf
Running head: SCREENING FOR LUNG CANCER
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