Geographic disparities in lung cancer screening uptake in the United States using the 2021 United States Preventive...

While previous studies documented variability in lung cancer screening (LCS) based on demographic, socioeconomic, and health related factors, less is known about geographic variation in LCS uptake. Using a nationally representative sample, we examined LCS uptake under the revised 2021 United States Preventive Services Taskforce guidelines according to U.S. Census region and metropolitan status.

Data were obtained from the 2022 Behavioral Risk Factor Surveillance System. Multivariable logistic regression models were used to examine associations between geographic region and LCS uptake. Stratified analysis was conducted to assess variability in LCS uptake by metropolitan status within each region.

Overall, 17.24% of eligible participants underwent LCS in 2022. LCS uptake was highest in the Northeast (21.95%) followed by the Midwest (17.74%) and the South (16.68%), while the lowest LCS uptake was reported in the West (13.41%). Individuals residing in the South (OR: 0.73; 95% CI: 0.66-0.81), Midwest (OR: 0.78; 95% CI: 0.71-0.86), and West (OR: 0.56; 95% CI: 0.51-0.63) were less likely to undergo LCS than those in the Northeast. LCS uptake was 18% lower among those residing in rural than their urban counterparts (OR: 0.82; 95% CI: 0.76-0.88). In stratified analysis, LCS uptake was significantly lower in rural areas than urban areas within each U.S. census region.

Findings suggest considerable variability in LCS across U.S. geographic regions, with lower uptake in areas with higher lung cancer burden. To reduce lung cancer disparities, geographically targeted interventions to promote LCS may be warranted.