Does neighborhood or residence influence continued smoking among cancer patients: a spatial-ecological and descriptive analyses brief report.

PURPOSE: Continued smoking after a cancer diagnosis is causally linked to cancer-specific and all-cause mortality. Additionally, smoking, in particular after a cancer diagnosis, increases risk for poor therapeutic outcomes, chronic disease and even COV19 infection. METHODS: In order to better understand and address continued smoking among cancer patients, this research applied geospatial mapping analysis to explore the potential association of dedicated smoke/vape shops density and smoking among cancer patients. RESULTS: Our findings suggest that there is an association between dedicated smoke/vape shops density and continued tobacco product use among cancer patients who live in areas with greater numbers of smoke/vape shops and higher percentage of African Americans and low socioeconomic persons. In the City of Hope-Antelope Valley Center region with an average of 1.4 dedicated smoke/vape shops per sq ml, cancer patients continue to smoke at a rate of almost 10%. This rate is almost twice the 5.2% cancer patient smoking rate of the main cancer center with an average of < 1 dedicated smoke/vape shops per sq ml. CONCLUSION: Our study may inform cessation-related research, practice and policies so that researchers, clinicians and policymakers are well-aware of these disparities in dedicated smoke/vape shops proliferation that is disproportionately affecting minority patient, in particular cancer population.

A Lung Cancer Screening Education Program Impacts both Referral Rates and Provider and Medical Assistant Knowledge at Two Federally Qualified Health Centers.

BACKGROUND: Federally Qualified Health Centers (FQHCs) serve minority and low-socioeconomic populations and provide care to high-risk smokers. These centers frequently experience barriers, including low provider and medical assistant (MA) knowledge around lung cancer screening (LCS). Subsequent low LCS referral rates by providers at FQHCs limit utilization of LCS in eligible, high-risk, underserved patients. METHODS: Providers and MAs from two FQHCs participated in a LCS educational session. A pre-educational survey was administered at the start of the session and a post-educational survey at the end. The intervention included a presentation with education around non-small cell lung cancer, LCS, tobacco cessation, and shared-decision making. Both surveys were used to evaluate changes in provider and MA ability to determine eligible patients for LCS. The Pearson's Chi-squared test with Yates' continuity correction was used to measure the impact. RESULTS: A total of 29 providers and 28 MAs enrolled in the study from two FQHCs. There was an improvement, P < .009 and P < .015 respectively, in provider and MA confidence in identifying patients for LCS. Additionally, one year prior to the program, 9 low-dose computed tomography (LDCTs) were ordered at one of the FQHCs and 0 at the other. After the program, over 100 LDCTs were ordered at each FQHC. CONCLUSIONS: A targeted LCS educational program improves provider and MAs' ability to identify eligible LCS patients and is associated with an increase in the number of patients referred to LDCT at FQHCs.

Implementing Lung Cancer Screening and Prevention in Academic Centers, Affiliated Network Offices and Collaborating Care Sites.

Lung cancer is one of the deadliest and yet largely preventable neoplasms. Smoking cessation and lung cancer screening are effective yet underutilized lung cancer interventions. City of Hope Medical Center, a National Cancer Institute (NCI)- designated comprehensive cancer center, has 27 community cancer centers and has prioritized tobacco control and lung cancer screening throughout its network. Despite challenges, we are implementing and monitoring the City of Hope Tobacco Control Initiative including 1) a Planning and Implementation Committee; 2) integration of IT, e.g., medical records and clinician notification/prompts to facilitate screening, cessation referral, and digital health, e.g., telehealth and social media; 3) clinician training and endorsing national guidelines; 4) providing clinical champions at all sites for site leadership; 5) Coverage and Payment reform and aids to facilitate patient access and reduce cost barriers; 6) increasing tobacco exposure screening for all patients; 7) smoking cessation intervention and evaluation-patient-centered recommendations for smoking cessation for all current and recent quitters along with including QuitLine referral for current smokers and smoking care-givers; and 8) establishing a Tobacco Registry for advancing science and discoveries including team science for basic, translation and clinical studies. These strategies are intended to inform screening, prevention and treatment research and patient-centered care.