Lung Cancer Screening for the Poor and Underserved: Should Routine Screening be Performed?

Area of Science:

• Oncology
• Public Health
• Health Disparities

Background:

• Lung cancer remains a leading cause of death in the United States.
• Low-dose CT screening has demonstrated reduced mortality in long-term smokers, though not yet standard care.
• Disparities in healthcare access and outcomes exist among different socioeconomic groups.

Purpose of the Study:

• To compare lung cancer diagnosis stages across different income levels.
• To evaluate the potential impact of socioeconomic status on early lung cancer detection.

Main Methods:

• Analysis of lung cancer data (stages 0-4) from 1,412 individuals.
• Inclusion of patients from a public hospital (lower income) and two private hospitals (higher income).
• Comparison of diagnostic stage distributions between socioeconomic groups.

Main Results:

• Significantly lower percentages of early-stage lung cancer (stages 0 and 1) were diagnosed at the lower-income public hospital (8.55%).
• Higher percentages of early-stage diagnoses were observed at higher-income private hospitals (NSUH: 36.18%, LIJ: 35.70%).
• Statistical significance (P < 0.001) confirmed the disparity in early-stage diagnosis rates.

Conclusions:

• Evidence supports lung cancer screening reducing mortality in smokers.
• Debate continues regarding universal screening recommendations.
• Screening for lower socioeconomic populations may be a recommended strategy, even if not for the general population.