Likelihood of Lung Cancer Screening by Poor Health Status and Race and Ethnicity in US Adults, 2017 to 2020

Rustagi, Alison S; Byers, Amy L.; Keyhani, Salomeh

doi:10.1001/jamanetworkopen.2022.5318

Cited by 34 publications

(33 citation statements)

References 63 publications

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“…This study is consistent with prior studies showing that Black individuals are less likely to receive an initial LCS, and when they do undergo LCS, they are about 30% less likely to receive the recommended follow-up ( 2 – 4 ). These are highly concerning findings as Black men have the highest lung cancer incidence and mortality from lung cancer of any demographic group ( 5 ), and Black populations may derive greater relative mortality benefits from screening ( 6 ).…”

supporting

confidence: 91%

Addressing Lung Cancer Screening Disparities: What Does It Mean to Be Centralized?

Núñez

Triplette

2022

Annals ATS

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supporting

confidence: 91%

Addressing Lung Cancer Screening Disparities: What Does It Mean to Be Centralized?

Núñez

Triplette

2022

Annals ATS

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“… 3 Despite having greater lung cancer incidence, Blacks are less likely to be eligible for screening given their lower average cigarette per day consumption and are nearly half as likely to report undergoing LCS than their White counterparts. 7 , 19 It is possible that with a lower pack year smoking history there will be an increase in the proportion of eligible Black patients, 7 however even the updated 2021 USPSTF guidelines do not take into account racial, ethnic, or socioeconomic differences in smoking patterns and lung cancer risk and may not be optimal for high risk populations like underrepresented minorities. 19 …”

Section: Discussionmentioning

confidence: 99%

Access to Care Limits Lung Cancer Screening Eligibility in an Urban Safety Net Hospital

Dollar

Neutel

Hsia

2022

J Prim Care Community Health

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Purpose: Lung cancer screening (LCS) results in earlier detection of malignancy and decreases mortality but requires access to care to benefit. We assessed factors associated with timing of lung cancer diagnosis in the absence of systematic LCS in an urban safety net hospital. Patients and Methods: Retrospective chart review was performed of patients with pathologic diagnosis and/or staging of lung cancer at our institution between 2015 and 2018. Patient socio-demographics, disease characteristics, factors associated with access to medical care, and time point and process by which the patient accessed care were collected and analyzed. Results: In total, 223 patients were identified with median age of 63 years and 57.8% male predominance. Racial distribution was 22.9%, 20.2%, 17.1%, and 9.4% for Black, White, Asian, and Hispanic, respectively. Stage at diagnosis was 8.1%, 4.5%, 17.0%, and 60.5% for stages I, II, III, and IV, respectively. Medicaid (59.6%) and Medicare/Medicaid (17.1%) were the most common insurance types, while 16.1% had no insurance. A majority (54.3%) had no established primary care provider (PCP), and only 17.9% had an in-network PCP. Patients without PCPs were more likely to have diagnostic evaluation initiated from Emergency Department or Urgent Care settings (95.0% vs 50.1%, P < .01) and present with later stage disease (92.7% vs 77.8%, P < .01). Of the 83 patients that met age and smoking history LCS criteria, only 33.7% (12.6% of total) also had an in-network PCP. Conclusion: Absence of established PCPs is associated with later stage presentation of lung cancer and may limit system- level benefits of LCS implementation.

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“…The current evidence that low‐dose helical computed tomography (LDCT) reduces lung cancer mortality comes primarily from two randomized controlled trials 8,12–14 . From 2002 to 2004, the National Lung Screening Trial (NLST) was carried out by the American Lung Cancer Screening Research Group 10,15–17 . A total of 53 454 people at high risk of lung cancer were included, and they were randomly divided into LDCT group and chest X‐ray group.…”

Section: Introductionmentioning

confidence: 99%

“…8,[12][13][14] From 2002 to 2004, the National Lung Screening Trial (NLST) was carried out by the American Lung Cancer Screening Research Group. 10,[15][16][17] A total of 53 454 people at high risk of lung cancer were included, and they were randomly divided into LDCT group and chest X-ray group. Compared with chest X-ray, LDCT can reduce lung cancer mortality by 20%.…”

Section: Introductionmentioning

confidence: 99%

Investigation on the incidence and risk factors of lung cancer among Chinese hospital employees

Chen

Kang

et al. 2022

Thoracic Cancer

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Objective In recent years, the lung cancer incidence has grown and the population is younger. We intend to find out the true detection rate of pulmonary nodules and the incidence of lung cancer in the population and search for the risk factors. Method Hospital employees ≥40 years old who underwent low‐dose computed tomography (CT) lung cancer screening from January 2019 to March 2022 were selected to record CT‐imaging characteristics, pathology, staging, and questionnaires to investigate past history, smoking history, diet, mental health, etc. PM2.5 and radiation intake in radiation‐related occupation received monitoring in hospital. Result The detection rate of suspicious pulmonary nodules was 9.1% (233/2552), and the incidence rate of lung cancer (including adenocarcinoma in situ) was 4.0% (103/2552). Morbidity among doctors, nurses, technicians, administers, and logistics was no difference (p = 0.184), but higher in women than in men (4.7% vs 2.4% p = 0.002). The invasiveness increased with age and CT density of nodules (p = 0.018). The relationship between lung cancer morbidity and PM2.5 was not clear (p = 0.543); and no lung cancer has been found in employees related ionizing radiation. Conclusion The high screening rate has brought about a high incidence of lung cancer. At present, the risk factor analysis of lung cancer based on small samples cannot find the direct cause. Most of the ground glass opacity (GGO)s detected by LDCT screening are indolent, but there are also rapidly progressive lung cancer. A predictive model to identify active and indolent GGO is necessary.

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Likelihood of Lung Cancer Screening by Poor Health Status and Race and Ethnicity in US Adults, 2017 to 2020

Abstract: This cross-sectional, population-based study examines rates of lung cancer screening to evaluate whether health status and racial and ethnic disparities are associated with rates of screening.

Cited by 34 publications

References 63 publications

Addressing Lung Cancer Screening Disparities: What Does It Mean to Be Centralized?

Addressing Lung Cancer Screening Disparities: What Does It Mean to Be Centralized?

Access to Care Limits Lung Cancer Screening Eligibility in an Urban Safety Net Hospital

Investigation on the incidence and risk factors of lung cancer among Chinese hospital employees

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