Moffitt wants to fight lung cancer, disparities with new set of wheels

A Chattanooga, Tenn. hospital introduced a novel piece of equipment in 2018: A refurbished bus outfitted with an X-ray body scanner. The bus traveled across Tennessee, Georgia and Alabama to provide lung cancer screenings.

Last fall, West Virginia’s WVU Cancer Institute began using its own mobile screening unit, this one pulled by a semi-truck.

Now, Moffitt Cancer Center hopes to add a mobile lung cancer screening unit that could be running in the Tampa Bay area by early 2024 if Moffitt succeeds in its bid for federal funding.

Experts say the mobile screenings can help marginalized and underinsured communities to combat the leading killer among cancers.

Less than a quarter of patients are first diagnosed with early-stage cancer, when the five-year survival rate is 60 percent, according to last year’s annual State of Lung Cancer report from the American Lung Association. Nearly half are diagnosed at late-stage, when the survival rate drops to just 6 percent. The prognosis is even more dire for Black, Latino and Indigenous Americans, all of whom have lower rates of early diagnosis, treatment and survival. (Asian Americans also have lower early diagnosis rates, but their survival rate is higher than that of white Americans.)

Many patients aren’t screened for lung cancer until they have symptoms, said Jhanelle Gray, chair of Moffitt’s thoracic oncology department.

“The cancer has spread” by then, she said. “It’s much less likely to be cured.”

Guidelines shared by the American Cancer Society say that screenings should be an annual event for people ages 50 to 80 who smoke cigarettes or have quit smoking within the past 15 years, and who have smoked a pack a day for 20 years, or two packs a day for 10. Before the pandemic, only about 5 percent of those eligible for screenings got them, Gray said. During the pandemic, that number dipped to between 3 and 4 percent. By comparison, she noted, about 70 percent of those eligible for breast cancer screenings receive them.

Part of the problem in detecting lung cancer, Gray said, is a lack of public awareness. Compared to long-established screenings for breast and colorectal cancer, which have high participation rates, the technology behind lung cancer screenings is new, with federal approval coming in the past decade.

Those in communities with the worst cancer outcomes may lack access to screenings. Research suggests that, overall, people of color are less likely to be screened for cancer than are white people. Though that’s not the case for every type of cancer screening, and though targeted efforts to reduce disparities have worked in some sectors, such as breast-cancer screening, Black patients still are less likely to be screened for several types of cancer, including lung cancer.

“I’m not sure we need more data on why we have access issues,” Gray said. “What we need is access.”

Cynthia Lumpkin’s family illustrates the difference early screening can make.

She said she now sees the factors that put her brother at risk for lung cancer: As a U.S. Marine, she said, Count Anthony Combs had been stationed at North Carolina’s Camp Lejeune, where exposure to contaminated drinking water was linked to a variety of cancers and other ailments. He later worked in the lumber industry, inhaling sawdust from treated wood — another occupation that carries an increased risk. And Lumpkin, who lives in Clearwater, recalled long car rides as kids, when their parents would light up with the windows sealed tight.

But Combs didn’t know he had cancer until he began coughing up blood. By then, it was too late. He died in 2014. A year later, Lumpkin signed up for a study at Moffitt that involved a screening, which depicted spots on her lungs. After surgery and chemotherapy, the cancer went into remission.

“I feel at peace,” said Lumpkin, 68, nearly seven years after her diagnosis.

John Demuro, Moffitt’s director of federal legislative affairs, said a mobile screening unit is a key part of Moffitt’s plans to push those low screening rates up. He pegged the price tag for a vehicle and the equipment at $2 million.

Moffitt will soon pitch the project to Rep. Kathy Castor, D-Tampa, as a candidate for next year’s round of federal Community Project Funding. It still would need to receive overall congressional approval; Demuro said he hopes the money would be appropriated by late this year or early 2023.

In the meantime, he said, Moffitt will explore other possibilities.

President Joe Biden promised a focus on both screening and addressing demographic health disparities as part of a relaunch this month of his cancer moonshot — setting a goal of cutting the death rate from cancer in half over the next 25 years.

The “reignition,” as the Biden administration put it, did not include more money. But Demuro said he’s hopeful that the initiative will mean more money for lung cancer screening down the road.

“If we don’t intentionally and strategically address certain groups, we know that they’re going to be at higher risk,” Gray said.

“We need to create equity for all of our patients,” she said. “We need to create the infrastructure, and we need to make sure we’re delivering on our promises.”

The Foundation for a Healthy St. Petersburg provides partial funding for Tampa Bay Times stories on equity. It does not select story topics and is not involved in the reporting or editing.