• Lung cancer screenings dropped by 75 percent in 2020 and 2021 due to the COVID-19 pandemic.
• One large hospital implemented a telemedicine program in which lung cancer screenings were conducted virtually.
• In a recent study, researchers reported that these virtual screenings were just as effective as the previous in-person ones.

Doctor visits are important — but can sometimes prove challenging for those with limited time or transportation, or conditions that restrict their mobility. Telemedicine, which enables a person to speak directly with their doctor via a computer or telephone, is making it easier for people to meet with their doctors and receive potentially lifesaving guidance.

In fact, new research shows that health care providers can use telemedicine visits to screen for lung cancer as effectively as in-person visits. The study was published in November in the Journal of the American College of Surgeons.

Lung cancer screening tests can help detect lung cancer early, before symptoms develop. Regular screening can reduce a person’s chances of dying from lung cancer. Experts recommend yearly lung cancer screening for people aged 50 or older with a long history of smoking.

Many health care providers stopped providing lung cancer screenings during the pandemic. According to the report, lung cancer screenings dropped by 75 percent since March 2020, due to worries about COVID-19 exposure as well as financial hurdles.

Telemedicine Reduces Risks, Increases Access

Doctors at Temple University in Philadelphia developed a telemedicine program in which people at risk for lung cancer could continue to have screenings virtually. For this type of screening, a person first undergoes a computed tomography (CT) scan at a hospital or imaging center. Afterward, they meet with their doctor over the phone or a video call to discuss follow-up options, rather than the traditional method of meeting face-to-face in the doctor’s office.

Lead study author Dr. Cherie P. Erkmen outlined for MyLungCancerTeam some of the benefits of using telemedicine for lung cancer screenings. Among them:

• People can save time and money by not having to drive — or arrange for a ride — to see a doctor face to face.
• Meeting with a doctor remotely lets a person limit their exposure to illness such as COVID-19 in clinic or hospital waiting rooms.
• They don’t need to worry about wearing a mask, which means they can see their doctor’s faces and vice versa. “Also, many patients have COPD [chronic obstructive pulmonary disease] or breathing difficulties, or require oxygen. Wearing a mask is not easy for them,” Dr. Erkmen said.
• They are free to have their families join in on the visits by telemedicine. “During COVID, many visits we are limited to only the patient in the provider,” Dr. Erkmen noted.

In the study, doctors analyzed which groups of people used telemedicine screening services compared with the previous in-person option. They also looked at the outcomes of these screenings.

Temple University serves many African American individuals. This group tends to be less likely to receive lung cancer screenings and treatments. The study authors initially feared that African Americans would get screened at even lower rates during the pandemic. However, they found that their telemedicine program continued to reach this population — African Americans were just as likely to receive virtual screenings during the COVID-19 pandemic as they were to receive in-person screenings before the pandemic.

Rate of Follow-Up Procedures the Same After Virtual Screenings

The study authors also looked at what happened once people received lung cancer screening. People were diagnosed with lung cancer at similar rates during in-person and virtual visits. They also received follow-up procedures — such as additional tests and surgery — at similar rates. For example, after in-person screening visits, 0.4 percent of people underwent a CT-guided biopsy (a procedure in which a small piece of lung tissue is removed for further testing). By comparison, after telemedicine screening visits, 0.5 percent of people underwent a CT-guided biopsy.

The researchers concluded that their telemedicine approach worked well and could continue to be an effective option in the future for people who needed lung cancer screenings.

In a video discussing the study, Dr. Erkmen said that moving forward, doctors should continue to use all types of screening approaches. “I think it’s important to realize that it doesn’t have to be one or the other, in-person or telemedicine,” she said. “We are, nationwide, only screening 3 to 6 percent of eligible people. There’s a huge missed opportunity to decrease lung cancer mortality in the United States, and we’re not taking it.”

“We should really be looking at all different means of engaging patients and maybe even using a combination,” Dr. Erkman continued. “Whatever it takes, we need to get more people screened.”