Since 2002, Candace Johnson has been an integral member of Roswell Park, serving as deputy director and chair of the Department of Pharmacology and Therapeutics for more than a decade before her appointment as president and CEO in 2015.

Recently, Dr. Johnson kicked off a new mobile lung cancer screening program supporting underserved communities. The first phase, which began in November 2022, focused on serving firefighters in Buffalo and the surrounding areas, a population that is especially susceptible to lung cancer due to the nature of their work.

HCB News checked in with Dr. Johnson to learn more about the program.

HCB News: Can you tell us a bit about your background in healthcare, and how you came to be CEO of Roswell Park Comprehensive Cancer Center in 2015?
Dr. Candace Johnson: I came to Roswell Park in 2002 from the University of Pittsburgh. While there, I was a professor of pharmacology, had my own laboratory and was Deputy Director of Basic Science for their cancer center. Roswell Park intrigued me because it is a freestanding cancer center — a model that allows cancer centers to be both focused and nimble in addressing the needs of their community — and I was offered the opportunity to lead translational research and build something special. When I got to Buffalo, I established a research program and was head of translational research for our Cancer Center Core Grant, the main mechanism for cancer centers to apply for funding and special designations from the National Cancer Institute. I later became a department chair, followed by Deputy Director, and I’ve been President and CEO for about 8 years now.

HCB News: What factors contributed to the decision to get lung cancer screening services out on the road?
CJ: When you look at something like mammography — with credit to longstanding advocacy efforts — around 90% of eligible women are getting screened for breast cancer. It’s a totally different story with lung cancer screening. In New York State, only 6% of eligible individuals are getting screened. And by the time someone may be showing symptoms, lung cancers are all too often diagnosed at advanced stages and can be more difficult to treat. We need to change that! Early detection is key.

We know that this is a tremendous opportunity to ramp up health equity for our region. The communities around Buffalo and Niagara Falls, New York, are marked by unusually high rates of lung cancer incidence and death — with the greatest impact in communities of color and rural areas. More than 36% of New York State residents living in counties with the highest rates of lung cancer deaths must drive at least an hour to get a low-dose CT scan. That is a huge obstacle, and one we can and must address.

Eddy stands for “Early Detection Driven to You” for a reason; we need to reach these individuals in their own backyards. Eddy is a fantastic model of a public-private partnership, as New York State recognized this need and helped us with critical startup funds, and Philips Healthcare provided us with the specialized imaging equipment capable of providing mobile low-dose spiral CT screening.

HCB News: Did Roswell Park have other mobile screening initiatives prior to EDDY? If so, did you learn anything from those initiatives that shaped the EDDY project?
CJ: We’ve had mobile community outreach efforts before, and we’ve done a lot of work to conveniently navigate the public to convenient cancer screening at a provider of their choice, but this is our first truly mobile cancer screening, and we hope to build the program from here.

HCB News: You’ve started by serving local fire fighters, who are at increased risk of lung cancer due to their work. What other groups do you plan to target in the future?
CJ: We’ve had a longstanding relationship with firefighters and other first responders because of that increased need. We know that firefighters with 20 or more years of service face 60% increased risk for lung cancer, a sixfold increase in breast cancer, and increased risk of many other cancers including leukemias, lymphomas, multiple myeloma, colon cancer and kidney cancer — all because of on-the-job exposures.

With the Eddy initiative, it’s been an honor for us to work with the Buffalo Fire Department and Buffalo Professional Firefighters Local 282 to bring Eddy to our local firehouses. It’s been a great partnership so far and we are expanding out from here.

Roswell Park’s continued strategic outreach will bring Eddy to communities across Western and Central New York — including neighborhoods on Buffalo’s East Side and West Side and around Niagara Falls that are home to many Black, Latinx, immigrant or refugee families as well as medically underserved rural communities and the sovereign Indian nations of the Haudenosaunee Alliance as our team is communicating with Federally Qualified Health Centers. We’d like to keep rolling Eddy out far and wide, reaching even more high-need urban and rural communities across the state.

One reason patients skip screening exams is because of the costs associated with healthcare. With EDDY, what is the patient experience like in terms of insurance, paperwork, and billing?
CJ: You’re not going to get screened if you feel like it’s a hassle. So, we’ve tried to make the process easy, affordable, and quick.

Those who meet eligibility requirements can fill out an intake form on the Eddy landing page of our website. Low-dose CT scans require a pre-authorization process, which takes about 3 days. We can’t have that turnaround time be a deterrent, so our teams onboard Eddy really work to educate the public about the importance of coming back to get that screening.

Every willing Buffalo firefighter, through our partnership, is screened free of charge, and we work with the public to ensure that they, too, can get in for a screening. Medicaid and Medicare mandate that those who are eligible have access to this potentially life-saving imaging, so we have seen major inroads to eliminating screening obstacles.

I’d love to see additional advocacy to eliminate pre-authorization windows as we see with screenings like mammograms or colonoscopies.

HCB News: What has the response been like from patients?
CJ: Response has been nothing short of incredible. We’ve had some of our self-referrals tell us they’re able to easily walk to Eddy, effectively reducing transportation barriers to screening. On top of access, patients have commented on how quick the whole process is. From start to finish, you’re onboard Eddy for about 10 minutes.

I’ve heard we’ve screened more than 500 individuals and found a few cancers, even detecting a kidney cancer that showed up on the scan and probably wouldn’t have been detected otherwise. So, when we say we know this will save lives, we mean it.

HCB News: Do you have any advice for providers who might be planning to implement their own mobile lung cancer screening unit?
CJ: We’ve already fielded calls from cancer centers across the country who are looking to bring this technology to their communities. Putting a low-dose CT scan on a trailer instead of inside a hospital? There’s going to be some finesse with that. We have a huge opportunity to save lives by working together and powering through the obstacles, so we’re happy to be a resource for anyone interested in making a program like Eddy a reality in their town or state.