Pictured (left to right): Nevada Cancer Coalition Executive Director Cari Herington, HGH Diagnostic Imaging Director Diane Klassen, and Nevada Cancer Coalition Board Member Kim Dupuis.
Lung cancer is the third most common cancer in the nation and was the leading cause of death for men and women in 2021, claiming the lives of an estimated 131,860 people, according to the results of study published by the National Cancer Institute.
The same study reported that early detection through lung cancer screening could decrease the death rate for lung cancer in Nevada by 20 percent, but sadly, Nevada is 49th in the nation for lung cancer screenings.
“To be able to bring up that rate even a little is really important to me,” said Humboldt General Hospital (HGH) Radiology Director Diane Klassen.
In August 2022, Klassen kicked off a lung cancer screening program at HGH that garnered the attention of the Nevada Cancer Coalition and earned her the Nevada Cancer Control Summit Award in September in Las Vegas, NV.
Over half of Humboldt County residents (55.4 percent) are reported to be smokers according to Klassen, and as a cancer survivor herself, the program is especially significant.
Klassen is a two-year survivor of breast cancer and has worked at HGH for 16 years, with almost 30 years of experience as a radiologic technologist.
The screening program at HGH uses Low Dose Computed Tomography (LDCT), a medical imaging technique that is preprogrammed to give a very low dose of radiation that can be very crucial in the early detection of lung cancer.
“Early detection saves lives,” said Klassen, and “The risk associated with the radiation exposure is worth the findings.”
As of July 2023, 97 LDCTs have been performed at HGH and the program has helped identify one finding of metastatic cancer, two cases of other findings that required short term follow ups, eight findings that were later found to be benign, and 21 incidental findings.
During the screening patients lie on their back while the LDCT images are taken of their chest—patients do not even have to change their clothes. After the images are collected they are turned up on their end from a different angle and the lungs can be seen in slices by the radiology technicians, similar to a loaf of bread, Klassen explained.
“When patients are here for mammograms and for these types of tests, they’re expecting to find cancer, so they can be really sensitive, they can be really scared. Our techs have to be a little more sensitive to that to the person’s mental state,” said Klassen.
Klassen’s program is even going to be used as a template for other hospitals and by the Centers for Disease Control and Prevention (CDC). She explained that she has created a sort of tool kit that hospitals can use with the correct bill codings that allow hospitals to more easily navigate Medicare payments.
Previously, the eligibility requirements for screenings through Medicare were a major barrier for patients and hospitals, but once the eligibility rules were loosened in February 2022 by the Centers for Medicare & Medicaid Services (CMS), the Medicare regulators, Klassen put together all of the information for the program in just a month.
The CMS lowered the previous screening age from 55 to 50 years and reduced the tobacco smoking history from at least 30 packs per year to at least 20 packs per year, which opened up screening to more people across the country.
Other eligibility factors include screening age from 50 to 80 for commercial insurance providers, shared decision-making consultation with a provider and an order, are currently smoking or have quit within the last 15 years, and the patient has no sign/symptoms of lung cancer.
Klassen explained that having access to a program such as this is very important, especially in a rural community, because people can go to their local hospital for the screenings.
“[Patients] are no longer having to travel to places like Reno for screening,” she said.
The Cancer Coalition has regarded Klassen as a “treasure for the community” and an “unsung hero” because of her work in launching the program locally and her work to help other medical professionals start and improve their own programs elsewhere.
“Klassen, an imaging specialist, launched the lung cancer screening program at Humboldt General, identified barriers, and worked to overcome them to get the program off the ground. She is a passionate advocate and partner, sharing her resources and lessons learned with other healthcare professionals and demonstrating that a quality lung screening program CAN work in a rural critical access hospital,” said Coalition officials.
Statistics in Nevada according to the American Lung Association:
• Nevada is 14 in the nation for lung cancer incidence at 53.3 per 100,000 people.
• Nevada is 49 in the U.S. for obtaining lung cancer screenings.
• The reported smoking rate in Humboldt County is 55.4 percent.
• The reported smoking rate in Nevada is 15.5 percent.
• The reported smoking rates for High Schoolers in Nevada is 4.8 percent.
• The reported vaping rates for High Schoolers in Nevada is 18.8 percent.