The U.S. Department of Veterans Affairs (VA) cares for thousands of Veterans diagnosed with lung cancer each year. Veterans experience a greater risk of lung cancer, and lung cancer is frequently diagnosed at advanced stages when chances for effective treatment and long-term survival are reduced. One strategy to improve lung cancer outcomes is annual lung cancer screening in patients at risk. Screening can detect cancers at an earlier stage when they are treatable and often curable.
While lung cancer screening programs save lives, they are complex and require dedicated resources and expertise. To bring these resources and expertise to the VA, Drew Moghanaki, MD, MPH, Section Chief of Radiation Oncology at the Atlanta VA Medical Center, launched the Partnership to Increase Access to Lung Screening (VA-PALS) in July 2017. VA-PALS is a multi-disciplinary collaboration among experts in primary care, pulmonology, radiology, thoracic surgery, radiation oncology, and computer science from within and outside VA. These experts have hundreds of years of collective experience implementing safe and effective lung screening programs around the world. They include leaders from the International Early Lung Cancer Action Program (I-ELCAP), which currently manages the world’s largest lung cancer screening program with more than 80,000 participants enrolled at 75 institutions.
VA-PALS is a three-year project that began with creating a software solution for managing patients who are undergoing screening. Software developers and VA clinicians worked together to adapt the I-ELCAP software system for VA. This system is scheduled for deployment at 10 VA medical centers across the country. It will automate many tasks involved in participant enrollment, tracking, and follow-up, and thereby increase the accuracy and efficiency of lung screening. The system will also collect data into a VA lung cancer registry that will allow VA investigators to identify occupational and environmental exposures that contribute to high rates of lung cancer among Veterans.
VA-PALS is a comprehensive program that supports all aspects of the screening program including the training of local radiologists in lung screening protocols and the use of “navigators” (advanced nurses) to educate and guide Veterans through enrollment and follow-up procedures. VA-PALS also promotes reduction in lung cancer risk factors and has the potential to increase the success of VA smoking cessation initiatives.