Black patients referred to a lung cancer screening program experience lower rates of screening and longer time to follow-up
- PMID: 32546140
- PMCID: PMC7298866
- DOI: 10.1186/s12885-020-06923-0
Black patients referred to a lung cancer screening program experience lower rates of screening and longer time to follow-up
Abstract
Background: Racial disparities are well-documented in preventive cancer care, but they have not been fully explored in the context of lung cancer screening. We sought to explore racial differences in lung cancer screening outcomes within a lung cancer screening program (LCSP) at our urban academic medical center including differences in baseline low-dose computed tomography (LDCT) results, time to follow-up, adherence, as well as return to annual screening after additional imaging, loss to follow-up, and cancer diagnoses in patients with positive baseline scans.
Methods: A historical cohort study of patients referred to our LCSP was conducted to extract demographic and clinical characteristics, smoking history, and lung cancer screening outcomes.
Results: After referral to the LCSP, blacks had significantly lower odds of receiving LDCT compared to whites, even while controlling for individual lung cancer risk factors and neighborhood-level factors. Blacks also demonstrated a trend toward delayed follow-up, decreased adherence, and loss to follow-up across all Lung-RADS categories.
Conclusions: Overall, lung cancer screening annual adherence rates were low, regardless of race, highlighting the need for increased patient education and outreach. Furthermore, the disparities in race we identified encourage further research with the purpose of creating culturally competent and inclusive LCSPs.
Keywords: Cancer Screening; Lung Cancer; Lung Cancer Screening; Lung Cancer diagnosis; Racial disparities; Screening adherence.
Conflict of interest statement
The authors declare that they have no competing interests.
Figures
References
-
- Centers for Disease Control and Prevention. What Are the Risk Factors for Lung Cancer? Atlanta, GA: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention; 2018 [updated July 19th, 2018. Available from: https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm.
-
- Force USPST. USPSTF Final Recommendation Statement: Lung Cancer Screening 2013 [Available from: https://www.uspreventiveservicestaskforce.org/Page/Document/Recommendati....
-
- Services CfMaM. Decision Memo for Screening for Lung Cancer with Low-Dose Computed Tomography (LDCT) (CAG-00439N) 2015 [Available from: https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo... NCAId=274.
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
