Association of Patient and Neighborhood Factors With Lung Cancer Screening Rates in Minnesota

Lung cancer is the second most common cancer and the leading cause of cancer deaths. Despite the known benefits of lung cancer screening, it is estimated to have low population uptake due to a variety of factors. We sought to estimate lung cancer screening rates in a large health system in Minnesota and study the factors affecting completion.

What are the rates of lung cancer screening chest CT scan ordered and completed in eligible populations in Minnesota's large integrated health system and its association with various socioeconomic factors?

We extracted records of patients likely eligible for lung cancer screening based on age and smoking history and determined their screening completion rates. Logistic regression models were used to evaluate associations. ORs and 95% CIs were calculated and evaluated at P = .05 for statistical significance.

Approximately 37% of patients with a smoking history were eligible for lung cancer screening. Approximately 12% of these patients had any CT chest scan completed, with only 7.2% being a screening-intent low-dose CT (LDCT) scan. The odds of screening were more strongly associated with age, smoking status, and gender than state Area Deprivation Index decile. Patients who previously smoked had twice the odds of having an LDCT scan order and greater odds of completion. People ≥ 65 years of age were more likely to have an order and completion than younger patients. Men had slightly lower odds of having an LDCT scan order than women, but they had greater odds of completion.

Our results suggest that the uptake of lung cancer screening continues to be low. Older patients, male individuals, and those who quit smoking were shown to be more likely to have a screening LDCT scan completed with no significant effect of state Area Deprivation Index decile.