Socioeconomic Disparities in Lung Cancer Screening Participation

Area of Science:

• Public Health
• Oncology
• Health Services Research

Background:

• Lung cancer screening in high-risk populations can reduce mortality.
• Effective national screening programs require equitable participation across diverse socioeconomic and demographic groups.

Purpose of the Study:

• To investigate associations between sociodemographic/socioeconomic factors and participation across stages of a risk-based lung cancer screening pilot program in Sweden.
• To identify potential barriers to equitable access in lung cancer screening.

Main Methods:

• A registry-linked cohort study was conducted in Stockholm, Sweden, from September 2022 to May 2024.
• Women aged 55-74 were invited to a pilot risk-based lung cancer screening program.
• Participation was assessed across three stages: initial questionnaire, eligibility for low-dose computed tomography (LDCT), and LDCT attendance.

Main Results:

• Of 34,592 invited women, 33.3% completed the questionnaire, 9.6% met LDCT eligibility, and 88.8% of eligible women attended.
• Initial questionnaire participation was higher among women with higher education, income, and favorable living conditions.
• Conversely, higher income and education were associated with lower likelihood of meeting LDCT eligibility criteria. Attendance among eligible women was equitable.

Conclusions:

• While LDCT attendance among eligible women was equitable, initial risk-assessment participation showed socioeconomic disparities.
• The design of risk-assessment tools is crucial for ensuring equitable access for socioeconomically disadvantaged groups in lung cancer screening.
• This study underscores the importance of addressing socioeconomic factors in the early stages of screening pathway design.