Disparities in Lung Cancer Screening: Demographic and Socioeconomic Influences

Lung cancer is the leading cause of cancer mortality in the U.S. Low-dose computed tomography is recommended for lung cancer screening in high-risk patients. The U.S. Preventive Services Task Force updated its recommendation for lung cancer screening in March 2021 to expand eligibility. This study aims to assess lung cancer screening rates and identify factors influencing lung cancer screening uptake under the new recommendations in Southeast Michigan.

A retrospective analysis was conducted on lung cancer screening-eligible patients from April 2021 to December 2023. Patients' demographics, clinical, and socioeconomic factors were extracted from electronic medical records. Multivariable logistic regression was used to identify factors associated with lung cancer screening uptake.

Of the 42,769 eligible patients, only 9,249 (22%) completed lung cancer screening at least once during the study period. Lung cancer screening rate increased from <10% in the first year to nearly 35% by the end of the study period. Higher uptake was observed in patients aged 60-80 years, females, former smokers, and Asian patients. Lung cancer screening was significantly less likely among patients of Middle Eastern or Arab ethnicity, patients of Black race, Medicaid beneficiaries, and those who lived in deprived ZIP codes.

Since U.S. Preventive Services Task Force expanded eligibility criteria, lung cancer screening rates remain suboptimal, with disparities across demographic and socioeconomic groups. Tailored, equitable interventions are critical to increasing screening uptake among high-risk and minority populations.