Maine Medical Center in Portland has won a four-year, $5 million grant to create a statewide initiative to expand services for the prevention and early detection of lung cancer, which occurs at a much higher rate in Maine than the national average.
“This gives us the opportunity to do a project that is truly statewide in reach and scope,” said Dr. Paul Han, who will lead the effort as director of the Center for Outcomes Research and Evaluation at the Maine Medical Center Research Institute.
Maine Med also received an additional $600,000 from two other funding sources to help launch the initiative, which will include an expansion of anti-smoking public education campaigns.
Han said Tuesday that one of the effort’s goals will be to improve access to preventive screenings for lung cancer.
“Lung cancer is such a big problem in Maine, and we are working to reach underserved populations in rural areas that have problems having access to health care,” he said.
Lance Boucher, the Maine director of public policy for the American Lung Association, said the program will be a substantial boon to prevention efforts.
“This is great news,” Boucher said. “It’s a comprehensive and robust initiative.”
Maine’s death rate for lung cancer is 53 per 100,000 population, the worst in the Northeast and higher than the national average of 45, according to 2012 statistics compiled by the U.S. Centers for Disease Control and Prevention, the latest year available. Maine’s overall smoking rate is similar to the national average, but there are pockets of rural Maine with high concentrations of smoking. Also, Maine is the oldest state in the nation, and cancer is more likely to strike as people age and become more vulnerable to diseases.
The Massachusetts-based Bristol-Myers Squibb Foundation awarded the grant to launch the Maine Lung Cancer Prevention and Screening Initiative, a four-year collaboration with Maine health care providers from multiple institutions. In addition to Maine Medical Center, the MaineGeneral Prevention Center, MaineHealth Center for Tobacco Independence, Maine Quality Counts, American Lung Association of the Northeast, American Cancer Society, University of Southern Maine Muskie School of Public Service, Eastern Maine Healthcare Systems and the Maine Public Health Association will be working on the project.
Han said adult smoking rates in rural areas of Maine are high, and telemedicine could be a key to getting people to the hospital for a CT scan, with the potential to catch lung cancer early. The screenings will save lives, Han said, and lower costs for the health care system in the long run. Preventing or treating early-stage cancer is much less expensive than later-stage cases of the disease, Han said.
A patient diagnosed with late-stage lung cancer has only a 5 percent chance of living five more years, compared with about 50 percent if the cancer is caught earlier, according to the International Association for the Study of Lung Cancer.
“It’s an investment that’s going to pay off,” Han said.
Han said telemedicine – where a patient has a virtual appointment with a physician by using a smartphone or computer – could be used during consultations with patients to see whether they are good candidates for a CT scan, which provide 3-D imaging of internal organs and in recent years have become much more effective at finding early-stage cancer.
With people living in remote areas and transportation an issue, Han said telemedicine could prove to be an efficient way to deliver care. Han said another goal of the project will be to determine where CT scans can be obtained in the state and how best to get patients to the screenings.
“We want to do a thorough inventory of our screening capacity throughout the state,” Han said.
In 2015, Medicare started reimbursing hospitals for CT scans for lung cancer patients, for longtime smokers age 55 or older. Han said with Medicare covering the scans, private insurance companies and Medicaid in future years will be more likely to also provide coverage.
As part of the program, MaineGeneral Medical Center in Augusta will be hiring three community health workers in addition to the five already on staff. The workers will fan out into rural areas and try to connect people to care, and encourage smokers to enter smoking cessation programs.
The initiative will work on educating primary care doctors on the importance of working with patients on smoking cessation programs and getting patients into screenings, Han said.
Another focus, Han said, will be to boost efforts to test homes for radon, which is another cause of lung cancer and a problem in Maine.
Emily Brostek, executive director of Consumers for Affordable Health Care, an Augusta-based health advocacy group, said the grant is “great news” for public health prevention and education.
“There are so many barriers to people getting the care that they need,” Brostek said.
The other funders are the Maine Cancer Foundation, which will contribute $400,000 over four years, and the Maine Economic Improvement Fund through the University of Southern Maine, which will chip in $200,000 for the project.
“Over a quarter of Maine’s cancer patients have lung cancer. The case for (the Maine Cancer Foundation) to co-fund this initiative was obvious and compelling,” Tara Hill, executive director of the Maine Cancer Foundation, said in a written statement.
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