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Spatial accessibility for deploying mobile lung cancer screenings in a rural state using two-step floating catchment
Janis E Campbell1,2, Ayesha B Sambo2, Nubwa St James1
1Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, 801 NE 13th Street, Oklahoma City, OK 73104, USA.
Objective:
Lung cancer remains the leading cause of cancer death in the United States. Mobile screening units have reduced access barriers. To assess lung cancer screening spatial access, we utilized a two-step floating catchment analysis (2SFCA) and an enhanced two-step floating catchment analysis (E2SFCA) to identify areas for mobile screening deployment.
Methods:
A spatial analysis was conducted using 2019-2023 census block group population data (ages 50-80) and a validated list of 165 lung cancer screening facilities in Oklahoma collected between December 2024 - May 2025, United States. Block groups were categorized into four spatial access groups. Analyses incorporated rural-urban continuum area codes. The 2SFCA used 30-min drive-time catchments, while the E2SFCA applied gravity-weighted 10-, 20-, and 30-min catchments.
Results:
Across both methods, 41 % of eligible Oklahomans resided in low or no spatial access areas, covering over 60 % of the state's land. Small rural areas had the highest proportion of residents (up to 67 %) with limited or no spatial access. Urban areas showed better spatial access, but up to 19 % of eligible residents still lacked 30-min access.
Conclusions:
Large sections of Oklahoma, particularly rural, lack spatial access to lung cancer screening. The 2SFCA and E2SFCA methods effectively identified underserved regions.
