# Development and Implementation of the REmote Telehealth User-Reported caNcer Surveillance (RETURNS) Program for Lung Cancer

> **NIH AHRQ R01** · NORTHWESTERN UNIVERSITY · 2023 · $359,963

## Abstract

ABSTRACT
 Although lung cancer is the leading cause of cancer-related death in the United States, over 540,000
Americans survive with treatment, making it the 4th leading diagnosis of cancer survivors.1,2 Surveillance is an
essential part of survivorship care to detect recurrent disease and/or a second primary lung cancer, monitor
treatment toxicity, reinforce smoking cessation, and manage patient fear of potential recurrence.3,4 Given
recent advances in lung cancer treatment, the number of new lung cancer patients needing surveillance care is
expected to increase faster than for any other cancer with 20% more lung cancer survivors eligible for
surveillance in 2022 than the decade prior.2 Indeed, the importance of research to improve cancer surveillance
was recognized by the Institute of Medicine as a “top 25 priority” for comparative effectiveness research.5
 Consensus surveillance guidelines recommend surveillance visits, with a chest computed tomography (CT)
and symptom review, every 6 months for the first 2 years following resection and, then, yearly thereafter.
Unfortunately, only 26% of patients receive the guideline-recommended CT and 39% are lost to all
follow-up after lung cancer resection.9-11 Patients have identified numerous barriers to surveillance visits,
including travel distance, time away from work, cost, and inconvenience to family members, factors that
disproportionately affect minority and low income populations, and may exacerbate disparities.12
 However, signs and symptoms of recurrence can be gathered from patients and caregivers using remote
assessments of Patient-Reported Outcomes (PROs), such as the Patient-Reported Outcomes Measurement
Information System (PROMIS), developed at our institution13-24 and travel and time barriers can be mitigated by
telehealth.25 However, use of PROs and telehealth for cancer surveillance remains poorly optimized. In
2019, our group implemented a REmote Telehealth User-Reported caNcer Surveillance (RETURNS) that uses
PROMIS instruments to remotely elicit select signs and symptoms,13-24 asynchronous review of electronically
submitted chest CT scans, followed by a telehealth visit. Preliminary data demonstrate considerable patient
enthusiasm for surveillance using telehealth, high degree of provider engagement, and economic feasibility.26
Nevertheless, “one size does not fit all” and it is, therefore, important to determine which patients are
appropriate candidates for remote PRO assessment and a telehealth visit. To do so, we will assess “end”
user (patients, caregivers, lung cancer clinicians) perspectives, at five diverse hospitals, to inform a user-
centered design of a Decision Aid to guide appropriate patient selection for RETURNS and to optimize the
delivery of RETURNS. Finally, we will evaluate the effect of RETURNS on patient and provider satisfaction and
its potential to improve adherence to surveillance guidelines, reduce surveillance disparities, and reduce
patient and healthcare ...

## Key facts

- **NIH application ID:** 10802764
- **Project number:** 1R01HS029343-01A1
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** David D. Odell
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2023
- **Award amount:** $359,963
- **Award type:** 1
- **Project period:** 2023-09-30 → 2023-10-01

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10802764

## Citation

> US National Institutes of Health, RePORTER application 10802764, Development and Implementation of the REmote Telehealth User-Reported caNcer Surveillance (RETURNS) Program for Lung Cancer (1R01HS029343-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10802764. Licensed CC0.

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