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Published on: September 8, 2023
The Impact of Downstream Procedures on Lung Cancer Screening Adherence
Tina D Tailor1, Sarah Bell2, Ruth C Carlos3
1Cardiothoracic Radiology Fellowship Director; Research Director, Duke Lung Cancer Screening Program; and Associate Professor, Department of Radiology, Duke University Medical Center, Durham, North Carolina.
Downstream procedures after lung cancer screening (LCS) can decrease repeat screening adherence. Reducing false positives and patient costs is crucial for maintaining LCS participation.
Area of Science:
- Pulmonary Medicine
- Radiology
- Health Services Research
Background:
- Lung cancer screening (LCS) aims to detect lung cancer early.
- Understanding downstream procedures and their impact on screening adherence is vital.
Purpose of the Study:
- To evaluate downstream procedures following LCS in individuals without screen-detected cancer.
- To determine the association between repeat LCS and downstream procedures/patient characteristics.
Main Methods:
- Analysis of deidentified data from 23,640 individuals undergoing 30,521 LCS examinations.
- Frequency and cost assessment of diagnostic imaging and invasive procedures post-LCS.
- Generalized estimating equation modeling for repeat LCS likelihood.
Main Results:
- 17.7% of LCS examinations led to downstream testing, most commonly chest CT.
- Downstream diagnostic imaging and invasive procedures were associated with decreased likelihood of repeat annual LCS.
Conclusions:
- Downstream procedures following LCS may act as barriers to continued screening.
- Strategies to minimize false positives and reduce patient costs are needed to ensure LCS adherence.
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