Building on work he began when he was at the University of Kentucky (UK) College of Medicine, University of Colorado Cancer Center leader Jamie Studts, PhD, along with Timothy Mullett, MD, and Jennifer Redmond Knight, DrPH, from UK’s Markey Cancer Center, has received a grant from the National Cancer Institute (NCI) to take the first step in a multi-phase process to improve lung cancer screening efforts at 60 sites across the U.S.
“This project is about working with individual screening programs, helping them to provide more optimal services and support for lung cancer screening, and to do better and hopefully more screenings,” says Studts, co-leader of the Cancer Prevention and Control program at the CU Cancer Center. “We are optimistic that we can help programs achieve earlier diagnosis, a higher volume of screening, and retention that leads to declines in late-stage lung cancer diagnosis and lung cancer mortality.”
The grant is centered around the Quality Implementation of Lung Cancer Screening (QUILS™) system that Studts developed with Mullett and Knight when he served as assistant director of cancer prevention and control at the UK Markey Cancer Center. QUILS™, a data-driven system aimed at assessing and improving the quality of lung cancer screening programs, is one of three parts of the Kentucky Lung Cancer Education Awareness Detection Survivorship (KY LEADS) program that helped reduce lung cancer mortality in Kentucky — one of the states with the highest incidence of the disease — after launching in 2014.
“We were able to show that quality improved overall across the 10 programs that participated in QUILS™,” Studts says. “You can see the outcomes of our work in Kentucky, which historically has been the state with the highest incidence of and mortality from lung cancer; however, that has started to change. For the first time in recorded cancer data history, the American Cancer Society recently reported that lung cancer mortality among men in Kentucky has dipped below that of another state.”
Under a unique NIH funding mechanism called a UG3/UH3 grant, Studts, Mullett, Knight, and their collaborators at CU, UK, and the American College of Radiology have two years to refine the QUILS™ program and identify and enroll the 60 lung cancer screening sites across the country. If that milestone is reached, they will apply for an additional four years of funding to conduct the primary part of the research — a randomized trial to test the effectiveness of the QUILS™ protocol in improving the programs’ reach and effectiveness.
“The screening programs will be randomized to one of three conditions,” Studts explains. “One is a wait list where they only get the assessment with no follow-up intervention; another group will get all four components of the QUILS™ system; then there's a middle group that will get some components of the QUILS™ system. We're testing nothing versus something versus the whole thing — which rational combinations of the QUILS™ system are necessary to help screening programs improve the overall quality of their services, as well as the implementation outcomes that we're looking for.”
UK Markey Cancer Center Director B. Mark Evers, MD, says the award builds upon the foundation established by the Kentucky LEADS Collaborative, which over the past decade has transformed lung cancer screening and outcomes in Kentucky.
“Dr. Studts’s continued leadership of this work at the University of Colorado Cancer Center, alongside our Markey researchers, Dr. Mullett and Dr. Knight, will help determine how this proven system can be replicated nationwide to save lives across the country,” Evers says.
Among Studts’s collaborators on the project at the CU Anschutz School of Medicine are four members of the Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS) — Christina R. Studts, PhD, associate professor of pediatrics, Russell E. Glasgow, PhD, research professor in family medicine, Liza Creel, PhD, associate professor of health care policy research, and Jun Ying, PhD, professor of family medicine.
“We are excited about the opportunity to collaborate closely with investigators from the CU Cancer Center on this high-impact project,” the ACCORDS members say in a statement. “Investigators from the ACCORDS Dissemination and Implementation Science Core and Economic Analysis Core will team with experts from the CU Cancer Center and multiple departments with the CU Anschutz School of Medicine to target not only improved lung cancer screening and outcomes for individuals, but also our understanding of what strategies are most helpful — and cost-effective — for health care professionals and organizations seeking to improve the quality of their lung cancer screening programs.”
In addition to Knight and Mullett, UK researchers Joseph “Trey” Alexander, Allyson Yates, Katie Bathje, and Brent Shelton, PhD, are all part of the effort.
“This is an incredible opportunity for the QUILS™ group to expand the work of quality lung cancer screening across the country,” Knight says. “We have worked together for more than 11 years to change the lung cancer story throughout Kentucky, and we recently extended our reach to Mississippi and Nevada. With this new NCI grant, we are looking forward to expanding our impact even further in Arkansas, Colorado, Florida, Iowa, Maine, New Mexico, Oklahoma, Oregon, and beyond.”
Mullett says that since the QUILS™ work was implemented in Kentucky, it has been impressive to see fewer patients diagnosed with late-stage lung cancer, meaning more patients are surviving the disease.
“The collaboration between the investigators has been impressive and impactful in Kentucky and beyond,” Mullett says. “This is a fantastic opportunity to disseminate this process to many more communities and learn even more about optimizing lung cancer screening.”
CU Cancer Center Director Richard Schulick, MD, MBA, says the NCI grant further establishes the CU Cancer Center in research around lung cancer screening and prevention.
“The CU Cancer Center is excited to lead this work to improve implementation of lung cancer screening across the country,” he says. “Dr. Studts and his colleagues at the University of Kentucky Markey Cancer Center have developed a robust approach to improving lung cancer outcomes, and this new funding from the National Cancer Institute underscores the importance of rigorously testing their approach nationally.”