C77-39 Stage Shift Following Implementation of the Combined Lung Cancer Identification Program (CLIP) in a U.S. Community Hospital

Rationale To evaluate the effect of a Combined Lung Cancer Identification Program (CLIP) on stage at diagnosis of lung cancer in a hospital in the United States in 2018 compared to 2022. Methods This retrospective study compared patients with newly diagnosed lung cancer within the Frederick Health System in calendar year 2018 versus 2022, to evaluate the impact of CLIP. Patients were eligible for inclusion if they had a confirmed diagnosis of lung cancer at any stage during either 2018 or 2022. Stage at diagnosis was obtained from electronic medical records (Meditech Expanse) and classified using the American Joint Committee on Cancer (AJCC) staging system 8th Edition. Data were aggregated and compared between years to assess trends in stage distribution. Results A total of 123 patients were diagnosed with lung cancer in 2018 and 133 patients in 2022. In 2018, stage distribution was as follows: stage 0 (0.81%), stage 1 (29.27%), stage 2 (7.32%), stage 3 (23.58%), and stage 4 (39.02%). In 2022, the proportions were stage 0 (0.00%), stage 1 (43.61%), stage 2 (7.52%), stage 3 (20.30%), and stage 4 (28.57%). The proportion of early-stage diagnoses (stages 0–1) increased from 30.1% in 2018 to 43.6% in 2022, while late-stage diagnoses (stages 3–4) declined from 62.6% to 48.9%. This represents a significant stage shift toward earlier detection of lung cancer within the health system over the four-year period. Conclusion Between 2018 and 2022, the Frederick Health System observed a meaningful shift toward earlier-stage lung cancer diagnosis, with a notable increase in stage 1 presentations and a reduction in stage 4 disease. These findings suggest the positive impact of CLIP. CLIP is a comprehensive lung program including lung cancer screening, primary emphasis on incidental nodule follow up, growing adoption of complementary blood-based risk classification tools for identifying patients at high risk, integrated robotic bronchoscopy program and multidisciplinary lung cancer clinic. Incorporating comprehensive programs such as CLIP into routine practice may further enhance early detection, streamline diagnostic evaluation, and ultimately improve patient outcomes in lung cancer.