3 Key Questions | Community-Engaged Strategies to Improve Lung Cancer Screening

Three Key Questions

1. Can you tell us a little about your role and background, and why you focus on community engagement in your work?

I am a pulmonary and critical care doctor with a focus on advancing health equity in lung cancer through early detection. Lung cancer is unique compared to other types of cancer. Not only is it the leading cause of cancer-related death among both men and women in the U.S. and internationally, but it is also heavily stigmatized. For decades, tobacco companies have shifted blame onto individuals who smoke, framing tobacco addiction as a matter of willpower when, in fact, these companies intentionally added highly addictive substances like nicotine to their products and targeted vulnerable populations—all while continuing to profit enormously.

Annual lung cancer screening with a low-dose CT scan can reduce cancer mortality by approximately 20%. Yet, more than a decade after screening became available, only 5–10% of eligible individuals have undergone an initial screen. Black and Hispanic individuals, who are more likely to benefit from screening, are more than half as likely to be screened compared to white individuals. When we have asked Black and Hispanic individuals about their experiences with screening, many shared that they were initially paralyzed by fear when their doctor first mentioned it, thinking that the doctor was telling them they had lung cancer. Additionally, they are often unaware that lung cancer screening is a preventive measure and that it should be done annually.

Tailored, community-engaged strategies are essential to overcome the stigma and fear surrounding lung cancer. This work has shaped my focus on community engagement, ensuring that patients’ voices guide how we promote and deliver screening.

2. What have you found to be most effective in addressing gaps in lung cancer screening and care? How have you engaged the community in this research, and in what ways has this engagement strengthened your work? 

Addressing gaps in lung cancer screening requires multi-level, tailored interventions that increase awareness, reduce stigma and fear of cancer, and provide navigation support throughout the screening process and beyond.

One example of my work is a current project focused on training community health workers (CHWs, or, in Spanish, promotores de salud) to deliver tobacco treatment counseling and shared decision-making around lung cancer screening. Through direct engagement with community members and people with lived experience, we co-develop relatable and culturally tailored materials and messages that CHWs can deliver to their communities. Engaging the community to gather input into the materials ensures that the messaging is not only medically accurate but also resonates with the intended audience. This approach has strengthened the effectiveness of our interventions and built stronger trust between healthcare providers and the communities we aim to serve.

We also work to raise awareness about lung cancer screening through community events focused on cancer survivorship and health equity, such as Faces of Faith and the William A. Darity Black Men’s Health Forum. Additionally, we engage with local media, including the Health Matters radio show on 90.7 FM and Western Mass News during Lung Cancer Awareness Month.

3. We are excited to have you as part of the HCC’s new working group initiative that brings together academic and community partners to address the cancer burden in Massachusetts. As a member of the Lung Cancer Working Group, where do you see opportunities for HCC researchers and community partners to work together?

It has been a privilege to be part of the HCC Lung Cancer Working Group and to collaborate with such a committed and insightful group of individuals. Several exciting opportunities for collaboration have already emerged. For example, the group is exploring education and outreach efforts for a Massachusetts bill that would require information about lung cancer screening to be posted anywhere tobacco products are sold, such as at convenience store counters.

Here in Western Massachusetts, we have started our own chapter of the American Lung Cancer Screening Initiative at UMass in Amherst, thanks in part to support from the working group. Additionally, through connections with one of the group’s members who works with the American Cancer Society, we successfully applied for and secured a competitive American Cancer Society Quality Improvement Resource Consulting (QIRC) award. This award is helping us identify barriers to timely and appropriate care across the lung cancer continuum in Western Mass.

If you are doing collaborative work in the community and are interested in connecting with the Center for Cancer Equity and Engagement on community outreach and engagement activities, please email Jenny Reiner.