Adherence to Annual Lung Cancer Screening in a Centralized Academic Program

Area of Science:

• Pulmonary Medicine
• Radiology
• Health Services Research

Background:

• Adherence to lung cancer screening (LCS) protocols is crucial for reducing mortality.
• Sub-optimal adherence, especially for annual screening in low-risk findings, is a persistent challenge.
• This study evaluated annual LCS adherence in a centralized program for patients with low-risk findings.

Purpose of the Study:

• To assess adherence to annual lung cancer screening (LCS) protocols.
• To identify factors associated with adherence among patients with low-risk findings in a centralized screening program.

Main Methods:

• Retrospective observational cohort study of 337 patients undergoing low-dose CT (LDCT) screening.
• Inclusion criteria: Lung-RADS score of 1 or 2, with at least 15 months follow-up.
• Multivariable logistic regression analyzed patient characteristics and adherence to annual screening.

Main Results:

• Overall adherence to annual repeat LDCT was 73.5% for Lung-RADS 1 and 75.0% for Lung-RADS 2.
• Medicaid coverage was significantly associated with lower adherence compared to private insurance (aOR=0.37).
• No other patient characteristics were found to be associated with screening adherence.

Conclusions:

• The centralized screening program demonstrated high initial annual adherence rates.
• Socioeconomic factors, particularly for Medicaid recipients, may pose barriers to consistent annual lung cancer screening.
• Addressing these barriers is essential for maximizing the benefits of LCS programs.