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Published on: May 20, 2016
Geographic Access to Low-Dose CT Lung Cancer Screening in Tennessee: Disparities by Socioeconomic Variables,
Sima Namin1, Martin Whiteside2, R Eric Heidel3
1College of Medicine-Knoxville, Office of Research Support, University of Tennessee Health Science Center, Knoxville, Tennessee, USA.
Summary
Rural communities face significant barriers to lung cancer screening access, with longer travel times and fewer low-dose computed tomography (LDCT) sites. Targeted interventions are needed to improve geographic equity in screening availability.
Area of Science:
- Public Health
- Health Services Research
- Geographic Information Systems (GIS)
Background:
- Lung cancer screening with low-dose computed tomography (LDCT) improves outcomes but faces geographic access disparities.
- Understanding these inequities is crucial for equitable healthcare delivery.
Purpose of the Study:
- To quantify tract-level access to LDCT screening in Tennessee.
- To examine disparities in LDCT access based on rurality and Appalachian status.
Main Methods:
- Utilized an enhanced two-step floating catchment area (E2SFCA) index to measure LDCT site accessibility.
- Compared access across urban/rural and Appalachian/non-Appalachian strata using statistical tests.
- Assessed associations between access and sociodemographic factors.
Main Results:
- Identified 198 LDCT-capable sites across Tennessee.
- Found significant disparities in access, with rural residents experiencing longer travel times and more zero-access tracts.
- Access was highest in urban non-Appalachian and urban Appalachian areas, and lowest in rural areas.
Conclusions:
- Rural and Appalachian communities in Tennessee have suboptimal access to LDCT lung cancer screening.
- Interventions should focus on increasing service points in underserved regions like West Tennessee and enhancing capacity in East Tennessee.
- Improving navigation and referral systems is essential for rural and Appalachian populations.
