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Lung Cancer Screening Eligibility, Uptake, and Adherence in Puerto Rico, 2022.

Maira A Castañeda-Avila1, Eduardo J Santiago-Rodríguez2,3, William Rodríguez-Cintrón4

  • 1Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts.

JTO Clinical and Research Reports
|July 4, 2025
PubMed
Summary

Lung cancer screening (LCS) uptake is low in Puerto Rico. Eligible residents are half as likely to be up-to-date with LCS compared to U.S. populations, indicating critical gaps in care.

Keywords:
Cancer disparitiesHispanic or Latino healthLung cancer screeningPuerto Rico

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Area of Science:

  • Public Health
  • Oncology
  • Health Disparities

Background:

  • Lung cancer screening (LCS) with low-dose computed tomography (LDCT) reduces mortality but faces low uptake.
  • Puerto Rico, a U.S. territory, has limited data on LCS eligibility and utilization.
  • Barriers to LCS implementation in Puerto Rico require investigation.

Purpose of the Study:

  • Estimate LCS eligibility in Puerto Rico.
  • Assess LCS prevalence and up-to-date status among eligible individuals.
  • Compare LCS use in Puerto Rico with U.S. Hispanic and non-Hispanic populations.

Main Methods:

  • Cross-sectional study using 2022 Behavioral Risk Factor Surveillance System data.
  • Included adults aged 50-80 years with a ≥20 pack-year smoking history, current or recent smokers.
  • Analyzed self-reported initial and up-to-date LCS status using multivariable Poisson models.

Main Results:

  • 94,955 individuals in Puerto Rico (7.9% of population) were eligible for LCS.
  • LCS use prevalence: 28.4% in Puerto Rico, 27.6% U.S. Hispanic, 31.5% U.S. non-Hispanic.
  • Up-to-date LCS: 9.8% in Puerto Rico vs. 17.3% U.S. Hispanic and 18.1% U.S. non-Hispanic.

Conclusions:

  • Less than 10% of eligible Puerto Rico residents are up-to-date with LCS, significantly lower than U.S. populations.
  • Puerto Rico residents are half as likely to be up-to-date with LCS compared to U.S. non-Hispanics.
  • Implementing high-quality LCS in Puerto Rico is crucial for reducing lung cancer mortality and ensuring equitable care.