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Census Tract Rurality, Predominant Race and Ethnicity, and Distance to Lung Cancer Screening Facilities : An
Solmaz Amiri1, Candice L Wilshire2, Clemma Jacobsen Muller1
1Department of Medical Education and Clinical Sciences, Elson S. Floyd College of Medicine, Washington State University, Seattle, Washington (S.A., C.J.M., C.A., G.F.).
Annals of Internal Medicine
|January 13, 2025
Summary
Lung cancer screening access varies significantly by race and ethnicity. American Indian/Alaska Native communities face the longest distances to screening facilities, even after accounting for rurality.
Area of Science:
- Public Health
- Health Disparities
- Cancer Screening Access
Background:
- The U.S. Preventive Services Task Force recommends annual lung cancer screening (LCS) for eligible adults.
- Ensuring equitable access to LCS is crucial for early detection and improved outcomes.
Purpose of the Study:
- To investigate disparities in geographic access to LCS facilities based on race, ethnicity, and rurality.
- To quantify differences in travel distance to LCS for various demographic groups.
Main Methods:
- A cross-sectional ecological study analyzed U.S. census tract data.
- Road network distances to the nearest LCS facility were calculated and compared across racial/ethnic groups and rurality levels.
- Ordinary least-squares regression modeled associations between distance and census tract characteristics.
Main Results:
- The geometric mean distance to the nearest LCS facility was 6.5 miles.
- American Indian/Alaska Native (AI/AN)-majority tracts had distances 5.26 times longer than non-Hispanic White (NHW)-majority tracts.
- Distances were shorter in Asian, Black, and Hispanic-majority tracts, but these advantages diminished or reversed when adjusting for rurality.
Conclusions:
- Significant racial and ethnic disparities exist in geographic access to lung cancer screening facilities.
- Rurality only partially explains these access differences, highlighting the need for targeted interventions to improve LCS accessibility for underserved populations.
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