Congress Abstracts 2005

32

RISK FACTOR SCREENING TOOL FOR LUNG CANCER (RFST-LC) REVISED: PILOT DATA. Cynthia Chernecky, PhD, RN, AOCN^®, Medical College of Georgia, Augusta, GA.

Lung cancer is a leading cause of death. There is no self-administered screening tool to assist practitioners in diagnosing lung cancer at earlier stages for at risk populations in neglected and rural areas.

Bringing people to the healthcare system earlier can enhance earlier diagnosis. The revised RFST-LC was developed for general practice settings to alert practitioners of patients at risk. The tool is based on an in-depth literature review and prospective research. Items in the original tool included risk factors of environmen, job, genetics, symptoms, medications, comorbidities and biological/diagnostic markers.

Framework is based on self-care in screening of at-risk populations. Theoretical basis includes that earlier assessment leads to earlier diagnosis.

Twenty-five convenient lung cancer patients were prospectively interviewed and chart reviews. Measurement was a checklist format of 26 items. This pilot work resulted in the revised 14-item tool. In the future, the final tool will require a larger sample size, per power analysis, and patients with all types of lung cancer for validity establishment.

Of 26 factors tested, 16 were confirmed positive at a prevalence of > 24% and considered clinical significant for assessment by healthcare providers. The range of scores for positive items was 5 to 14. Two items were dropped for expense and low prevalence. From this data the revised 14-item tool was developed.

The top 4 items, above 80%, were cough, SOB, history of tobacco use and second hand smoke. Factors between 45%–65% were weight loss, job history, fatigue and current medications. Two new factors were discovered, bronchitis without complete resolve and consistent sputum production increase upon awakening. Of 26 items tested, 16 occurred in > 24%, 3 occurred in less than 24%, and 7 were ruled out. These results show promise for the continued development of a simple and easy tool to help clinicians begin to identify high-risk patients earlier. This can lead to further assessment and earlier diagnosis, particularly for vulnerable populations and those in healthcare poor environments. The newly revised 14-item RFSC-LC is based on the above pilot work.