About

Kentucky’s Lung Cancer Burden

QUILS™ was developed from a collaborative research project focused on improving lung cancer screening quality and reducing the burden of lung cancer in Kentucky. Kentucky has consistently had the highest rates of lung cancer diagnoses and deaths in the country.

Smoking
Kentucky is among states with the highest rates of smoking in the country.
Harmful Chemicals
Kentucky residents have a higher exposure to radon, coal, heavy metals, and hazardous occupational factors.
Poverty
Kentucky is among states with the highest rates of poverty, leading to tremendous health inequities.

Most lung cancer cases are diagnosed at a late stage and Kentucky public health, healthcare, governmental and nonprofit organizations decided it was time to work together to focus on changing Kentucky’s lung cancer story.

History of the QUILS™ System

2011: LDCT Reduces Lung Cancer Mortality

Results of the National Lung Screening Trial are published, identifying a lung cancer-specific as well as an all-cause mortality reduction associated with low-dose computed tomography (LDCT) in comparison to standard chest radiography (CXR) among individuals at high risk for lung cancer based on age and smoking history.

2011: LDCT Reduces Lung Cancer Mortality

2013: Kentucky Lung Cancer Network Launched

The Kentucky Cancer Consortium launches the Kentucky Lung Cancer Network, a statewide collaborative effort to convene partners across Kentucky to reduce the commonwealth’s nation-leading rates of lung cancer incidence and mortality.

2013: Kentucky Lung Cancer Network Launched

2013: BMSF Funding for Lung Cancer Survivorship

The Bristol Myers Squibb Foundation (BMSF) engages the Kentucky Lung Cancer Network to discuss a funding opportunity dedicated to supporting statewide lung cancer survivorship initiatives.

2013: BMSF Funding for Lung Cancer Survivorship

2013: USPSTF Recommends No-Cost LDCT Screening

The US Preventive Services Task Force (USPSTF) re-evaluates the available data on lung cancer screening and allocates a B grade recommendation, encouraging implementation among individuals who meet specific eligibility criteria. The link with the Affordable Care Act (ACA) makes LDCT available to eligible individuals as a preventive benefit at no out-of-pocket cost.

2013: USPSTF Recommends No-Cost LDCT Screening

2014: Grant Funds Kentucky LEADS Collaborative

The investigative team at the University of Kentucky, the University of Louisville, and the Lung Cancer Alliance (now Go2 for Lung Cancer) receive a large grant from the Bristol Myers Squibb Foundation to develop the Kentucky LEADS (Lung Cancer Education Awareness Detection Survivorship) Collaborative focused on (1) provider education, (2) survivorship care, and (3) prevention and early detection.

2014: Grant Funds Kentucky LEADS Collaborative

2015: CMS Adopts LDCT Coverage for Medicare

The Centers Medicare and Medicaid (CMS) completes the National Coverage Determination for LDCT and adopts coverage of lung cancer screening among Medicare beneficiaries who meet the eligibility criteria.

2015: CMS Adopts LDCT Coverage for Medicare

2015 – 2017: Kentucky LEADS Develops QUILS™ System

The Prevention and Early Detection Component of the Kentucky LEADS Collaborative develops the QUILS™ System 1.0 to facilitate implementation of high-quality lung cancer screening in diverse settings.

2015 – 2017: Kentucky LEADS Develops QUILS™ System

2018 - 2020: QUILS™ System Implemented in Kentucky

The QUILS™ System 1.0 is implemented and evaluated in 10 lung cancer screening programs across Kentucky.

2018 - 2020: QUILS™ System Implemented in Kentucky

2021: QUILS™ System Boosts Lung Screening Quality

Data examining the QUILS™ System 1.0 demonstrates improvement in quality implementation of lung cancer screening, and other data show that Kentucky’s rates of lung cancer screening are some of the highest in the country.

2021: QUILS™ System Boosts Lung Screening Quality

2021: USPSTF Updates Lung Screening Guidelines

The United States Preventive Services Task Force (USPSTF) updates their annual lung cancer screening guidelines to adults aged 50 to 80 years who are asymptomatic, have a 20 pack-year smoking history and currently smoke or have quit within the last 15 years.

2021: USPSTF Updates Lung Screening Guidelines

2022: QUILS™ Group Plans Expansion and Update

The lung cancer prevention and early detection component of the Kentucky LEADS Collaborative forms the QUILS™ Group. They received a planning grant from the Bristol Myers Squibb Foundation to adapt and translate the statewide initiative developed and implemented in Kentucky in two new states and update the QUILS™ System to version 2.0.

2022: QUILS™ Group Plans Expansion and Update

2022: CMS Updates Lung Screening Guidelines

The Centers Medicare and Medicaid (CMS) reconsiders the national coverage determination and updates their annual lung cancer screening guidelines to adults aged 50 to 77 years who are asymptomatic, have a 20 pack-year smoking history, and currently smoke or have quit within the last 15 years.

2022: CMS Updates Lung Screening Guidelines

2022: Grant Funds QUILS™ Virtual Learning Collaborative

The QUILS™ Group receives a grant from the Healthy Kentucky Initiative to leverage the QUILS™ System to develop and implement and virtual learning collaborative focused on facilitating equitable and high-quality lung cancer screening in Kentucky. The learning collaborative reaches over 100 engages partners, representing a broad array of disciplines (e.g., navigators, physicians, advocates, researchers, public health leaders, and payers).

2022: Grant Funds QUILS™ Virtual Learning Collaborative

2023: QUILS™ Partners with Anthem Medicaid

The QUILS™ Group partners with Anthem Medicaid to implement the updated QUILS™ System in a lung cancer screening program in Western Kentucky.

2023: QUILS™ Partners with Anthem Medicaid

2024: Grant Fuels QUILS™ System Implementation

The QUILS™ Group receives grant funding from the Kentucky Lung Cancer Screening Program of the Kentucky Department of Public Health to expand the implementation of the QUILS™ System to enhance equitable and high-quality lung cancer screening to additional sites in Kentucky.

2024: Grant Fuels QUILS™ System Implementation

2024: Grant Proposal for Multi-State Lung Screening Project

The QUILS™ Group is awarded a grant by the Bristol Myers Squibb Foundation to partner with the University of Mississippi Medical Center/Mississippi Lung Cancer Roundtable and the Nevada Cancer Coalition/Nevada Lung Cancer Group to implement and evaluate a statewide lung cancer screening implementation project in both states. The proposed project will include three components: (1) statewide collaborative, (2) clinician engagement initiative, and (3) the QUILS™ System 2.0 implementation.

2024: Grant Proposal for Multi-State Lung Screening Project

What is the QUILS™ System?

We built the QUILS™ system to help program leaders measure the quality of their lung cancer screening programs, identify areas of strengths and opportunities for improvement, and create action plans to improve help outcomes in their communities.

1. Proprietary QUILS™ Assessment
The QUILS™ Assessment is at the core of the QUILS™ System. It's a comprehensive measure of the performance of a lung cancer screening program across seven critical domains. The end result of taking the QUILS™ Assessment is our proprietary QUILS™ Index score, which gives a rating across each area of the lung cancer screening program that they will use to prioritize action.
2. Individualized Feedback
The QUILS™ Group works with the lung cancer screening program to create an individualized feedback report, complete with recommendations on how to increase their overall QUILS™ Index score. The QUILS™ team provides a presentation to report on their findings and an opportunity to engage in discussion on areas of strength and opportunity.
3. Industry-Leading Resources
Of course, it was not enough to know what a program’s weaknesses are – we also created a portal containing best-in-class resources to help these programs improve. Lung Cancer Screening Programs implementing the QUILS™ System have access to an ever-growing list of resources to help them improve across each domain.
4. Coaching and Support
In addition to our DIY Resource center, Lung Cancer Screening Programs get direct access to our team and to the QUILS™ Community - an online community of lung cancer screening professionals sharing their wealth of knowledge with each other.
5. Reassess and Improve
Lung Cancer Screening Programs who choose to stay in the QUILS™ System will have an opportunity to re-assess twice a year. This allows our team to monitor how changes in their program turn into better health outcomes in their community.

Measuring Progress

After 10 years of working with these ten lung cancer screening sites and remaining connected to the collective work of the Kentucky Cancer Consortium, the results were impressive.

Screening

Kentucky, a state that isn’t known for high rankings in health, improved to the #2 spot in the country for lung cancer screening rates.

National Average

Kentucky

Diagnosis

Late-stage lung cancer diagnosis rates have begun to dramatically decrease at a rate 2x faster in Kentucky than in the U.S. overall, and 3x faster in Appalachian Kentucky than the U.S. overall.

SEER 17 Excluding Kentucky

Kentucky Appalachian

NPCR

Kentucky

While there is still a long way to go and a lot of work ahead of us, these results show a lot of promise.

We are excited to take what we’ve learned in Kentucky to lung cancer screening programs across the nation.

Learning & Growing

As we look to the future, we are excited to expand our footprint and serve more sites across the nation. We are currently looking to partner with lung cancer screening programs and funding partners to expand our impact even more.

We are now actively working to expand the impact of the QUILS™ system. We’re looking inside and outside Kentucky for lung cancer screening programs who are looking to make an even bigger difference in their communities and lead the way in lung cancer early detection. If that sounds like you, we’d love to write the next chapter together.