FHIR Profiles for Detailed Smoking History (PSS-2199)

Lung cancer is the leading cause of cancer deaths in the US and worldwide, and lung cancer screening through low-dose computed tomography (CT) of the chest can reduce lung cancer deaths by about 20%. Thus, lung cancer screening is recommended for high-risk individuals by the US Preventive Services Task Force (USPSTF) ([https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening]) and professional clinical societies. 

Moreover, the Centers for Medicare and Medicaid Services (CMS) requires documentation of lung cancer screening shared decision making using a decision aid prior to starting a screening regimen with low dose computed tomography (LDCT) ([https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?proposed=N&ncaid=304]). Shared decision making using a decision aid is important because there is wide individual variation in the benefits that can be expected from lung cancer screening among screening-eligible patients, with the details of an individual's smoking history being a very important predictor of their lung cancer risk.

For both i) identifying patients who are eligible for lung cancer screening and ii) providing individualized risk assessment through a decision aid, information regarding key elements of a patient's smoking history are required. These key elements include i) years smoked, ii) average packs per day, and iii) if the patient has quit, how long it has been since the patient has quit.

The purpose of this project is to define these critical data elements to help reduce the #1 cause of cancer deaths in the US and worldwide.