Lung Cancer and the Colorado Cancer Plan


Lung Cancer the Colorado Cancer Plan

  1.1 Strategies:

  1. Establish, promote and enforce laws prohibiting the sale and restricting the marketing of tobacco products to minors, including increasing the allowable age to purchase tobacco products to 21 and increasing local point of purchase ordinances designed to protect minors.
  2. Increase the purchase price of tobacco products.
  3. Implement health systems change strategies to increase access to and use of evidence-based cessation services, including referrals to the QuitLine.
  4. Educate youth on the risks of all tobacco product use, including ecigarettes, and support positive youth development skills, targeting those under 18 years and those 18-24 years.
  5. Implement community outreach and education programs designed to reduce all forms of tobacco use.
  6. Institutionalize and standardize tobacco screening and evidence-based brief interventions such as Ask, Advise, Refer (AAR) or Ask, Advise, Assess, Assist or Arrange (5As).


1.2 Strategies:

  1. Maintain enforcement of no smoking rules within 25 feet of building entries.
  2. Develop, implement, monitor, protect, strengthen and expand policies that protect populations from secondhand smoke exposure at home, in outdoor public places, at work and in multi unit housing. For example, enact smoking bans in public housing units that also include an educational component about evidence-based cessation interventions.


1.3 Strategies

  1. Institutionalize and standardize tobacco screening and evidence-based brief interventions such as Ask, Advise, Refer (AAR) or Ask, Advise, Assess, Assist or Arrange (5As).
  2. Expand access to and use of tobacco cessation services, including the QuitLine; and treatment, particularly among Medicaid clients through health care delivery interventions.
  3. Implement media campaigns with cessation promotion messaging to increase the number of quit attempts and successes among smokers, focusing on low socioeconomic status adults.


4.1 Strategies

  1. Educate the Colorado public, home owners, building owners, sellers, Realtors and policymakers about radon and its risk for lung cancer.
  2. Educate builders, code officials, city councils and county commissioners on radon facts, health effects and implementation of radon-resistant features in new construction.
  3. Promote environmental equity through radon testing and mitigation programs and outreach efforts directed at minority or indigent populations.
  4. Engage and educate Realtors, home-buyers and sellers on the importance of radon testing and information disclosure during real estate transactions.


4.3 Strategies

  1. Encourage use of certified asbestos building inspectors prior to renovation or demolition activities.
  2. Educate homeowners on asbestos risk and requirements of the Air Quality Control Commission regulation 8, part B.
  3. Increase the number and accessibility of CNG/Biodiesel fueling stations and electric vehicle supply equipment (EVSE) systems.
  4. Develop a state and intrastate system of Compressed Natural Gas (CNG)/Biodiesel stations to increase their numbers and accessibility to promote and support local and long distance, commercial and diesel fleet use of alternative fuels.
  5. Educate diesel fleet owners/drivers about the benefits of alternative fuel, including reduced emissions and cost.
  6. Educate adults and students on the relationship between diesel exhaust and risks of respiratory illnesses and lung cancer.
  7. Promote and implement workplace policies to reduce exposure to carcinogens.


  5.1 Strategies

  1. Educate primary care providers on the importance of a provider recommendation and adhering to nationally recognized, evidence based cancer screening guidelines such as the United States Preventive Services Task Force (USPSTF), the National Comprehensive Cancer Network (NCCN), the American Cancer Society (ACS) and the American College of Radiology (ACR)
  2. Educate patients and primary care providers on the importance of early detection of lung cancer among those who are high risk, and on the risks and benefits of screening
  3. Implement client reminder systems (e.g., print or phone) to advise individuals in need of a cancer screening; messages may be tailored or general
  4. Implement provider oriented strategies, including provider reminders and recalls to identify when an individual is in need of, or overdue for, a cancer screening test based on individual or family history risk, and provider assessment and feedback interventions that present information about screening provision, in particular through use of an electronic health record system.
  5. Deliver one-on one or group education conducted by health professionals or trained lay people to motivate individuals to seek screenings by addressing indications for and benefits of screening, and what to expect during screening services. Use small media to support this education (e.g., brochures or newsletters).
  6. Implement workplace policies to provide paid time off for individuals to complete recommended cancer screenings,
  7. Collaborate with health plans to achieve increased cancer screening compliance rates, for example through the use of National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) cancer screening measures.
  8. Implement evidence-based practices through engagement of patient navigators in cancer screening processes.


8.1 Strategies

  1. Educate oncology providers on tobacco counseling and referral services.
  2. Implement evidence-based tobacco cessation programs in the cancer survivor population and advance policies that reduce out-of-pocket costs for evidence-based cessation treatments, such as medication and counseling.
  3. Track QuitLine calls from cancer survivors and provide direct education to survivors on the effects of tobacco on treatment efficacy, recurrence risk and second cancers.