Feature: Lung Diagnostic Assessment Program

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| 1 November 2023

Did you know that lung cancer causes more deaths than any other cancer? Unfortunately, significant differences in cancer survival outcomes exist across the province of Ontario for patients with newly diagnosed lung cancer.

Canadian data shows that people with lower income, and those who live in rural communities, are more likely to be diagnosed with lung cancer, while lower income is also associated with worse survival. These disparities are of particular concern in the Southeastern (SE) Ontario region, which serves a predominantly rural patient population with a significant percentage of low-income households.

The Lung Diagnostic Assessment Program (LDAP) at Kingston Health Sciences Centre (KHSC) is a rapid assessment clinic and most common clinical pathway for evaluation of patients with suspected lung cancer in SE Ontario. A recent analysis of SE Ontario data demonstrated that LDAP management is independently associated with improved lung cancer survival outcomes, and that increased patient distance from the regional LDAP was associated with reduced likelihood of LDAP management. As geographical distance is a potential modifiable barrier to care, an opportunity for improvement was identified.

Dr. Geneviève Digby and Dr. Christopher Parker launched an LDAP outreach clinic at a regional community hospital (Lennox and Addington County General Hospital (LACGH), Napanee) to address timeliness of care and reduce geographic and socioeconomic barriers related to lung cancer care in a rural population. The outreach clinic mirrors the tertiary care centre model, and was developed to provide timely and efficient assessment and initial consultation of patients referred with the suspicion of lung cancer.

In its first year since launching in 2021, the LDAP outreach clinic provided care to 121 patients and was able to reduce the average time from LDAP referral to assessment from 20 to 14 days. By providing care closer to home, total patient travel was reduced by 8,856km, which combined with parking cost-savings, resulted in patient out-of-pocket savings of CAD $5,755.60 (CAD $47.60/patient). Accounting for physician travel, total travel saved was 5,688km, corresponding to reduced CO2 emissions of 1.9 tons.

The value of this clinic is best captured in the words of Betty, one of the patients seen in the Napanee Outreach Clinic.

“It’s a lot more convenient for us to drive 25 minutes than over an hour to get to appointments and receive the care that we need. It makes a big difference, especially for people who are working or have children at home and need to schedule care or take time off work. Having the clinic this close was really beneficial. I was able to be followed regularly to get an early diagnosis and treatment. Having this clinic has been a wonderful experience and I can’t say enough good things about the team and the care I have received.”

Overall, the LDAP outreach clinic has led to improved timeliness of care, patient cost savings, and reduced carbon footprint, while providing tertiary-level service to patients in their community. Drs. Geneviève Digby and Chris Parker hope to continue to increase capacity at the outreach clinic and to build sustainability of the LDAP program in 2023.

Feature: Lung Diagnostic Assessment Program

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Feature: Lung Diagnostic Assessment Program

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