Disparities in Lung Cancer Screening: Demographic and Socioeconomic Influences

Area of Science:

• Oncology
• Public Health
• Radiology

Background:

• Lung cancer is a leading cause of cancer mortality in the U.S.
• Low-dose computed tomography (LDCT) is recommended for lung cancer screening in high-risk individuals.
• The U.S. Preventive Services Task Force (USPSTF) updated screening recommendations in March 2021, expanding eligibility criteria.

Purpose of the Study:

• To assess lung cancer screening rates in Southeast Michigan following the USPSTF 2021 guideline update.
• To identify demographic, clinical, and socioeconomic factors associated with lung cancer screening uptake.

Main Methods:

• Retrospective analysis of 42,769 eligible patients from April 2021 to December 2023.
• Extraction of patient data including demographics, clinical information, and socioeconomic factors from electronic medical records.
• Multivariable logistic regression analysis to determine factors influencing screening uptake.

Main Results:

• Only 22% of eligible patients completed lung cancer screening during the study period.
• Screening rates increased from under 10% to nearly 35% by the end of the study.
• Higher screening uptake was observed in older adults (60-80 years), females, former smokers, and Asian patients.
• Lower uptake was noted in patients of Middle Eastern/Arab ethnicity, Black race, Medicaid beneficiaries, and those in deprived areas.

Conclusions:

• Lung cancer screening rates remain suboptimal post-USPSTF guideline expansion.
• Significant disparities in screening uptake exist across demographic and socioeconomic groups.
• Tailored, equitable interventions are crucial to enhance screening in high-risk and underserved populations.