Lung Cancer Screening Eligibility and Utilization Among Transgender Patients: An Analysis of the 2017–2018 United States Behavioral Risk Factor Surveillance System Survey

Stowell, Justin T; Parikh, Yasha; Tilson, Kimberly; Narayan, Anand K.

doi:10.1093/ntr/ntaa127

Cited by 17 publications

(8 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Creating LCS eligibility criteria that accurately reflect cancer risk across different racial and ethnic groups is paramount to reducing LCS disparities. Aside from eligibility criteria, vulnerable patient groups experience numerous additional barriers (eg, racial and ethnic minority group biases, sexual orientation radiology.rsna.org n Radiology: Volume 000: Number 0-Month 2021 and gender minority group biases, low socioeconomic status, or uninsured patients) that limit equitable LCS access (10)(11)(12)(13)(14)(15). The reasons for this include a range of patient-level, provider-level, and system-level factors (16)(17)(18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

Racial and Ethnic Disparities in Lung Cancer Screening Eligibility

et al. 2021

View full text Add to dashboard Cite

A frican American patients are more likely to develop and die of lung cancer than White patients (1). The U.S. Preventive Services Task Force (USPSTF) recommends lung cancer screening (LCS) with low-dose chest CT to reduce lung cancer mortality. However, initial screening guidelines were derived from studies in which only 4% of study participants were African American smokers. Study investigators from the Southern Communities Cohort study, a prospective cohort study including 48 364 adult smokers in the southeastern United States, found that existing USPSTF guidelines may exclude a large percentage of high-risk African American smokers (2). Partly to address equity concerns, the USPSTF recently issued revised recommendations lowering the threshold for LCS eligibility from age 55 to age 50 and from at least 30 pack-years to at least 20 pack-years (3). However, rates of lung cancer for a given pack-year history are much higher in African American patients (4).Newly revised recommendations defining eligibility exclusively based on pack-year thresholds ignore racial and ethnic differences in lung cancer risk. Previous studies have suggested that USPSTF guidelines exclude high-risk racial and ethnic minority groups. However, few studies use recent data to evaluate the potential impact of revised USPSTF guidelines on racial and ethnic disparities in LCS eligibility. Our purpose was to evaluate the impact of revised USPSTF guidelines on racial and ethnic disparities in LCS eligibility using survey data from the 2019 Behavioral Risk Factor Surveillance System (BRFSS). Materials and MethodsOur study used publicly available de-identified data and was therefore exempt from institutional review board review. No data usage agreements were required. Study results were reported using Strengthening the Reporting of Observational Studies in Epidemiology guidelines (5).Background: To address disparities in lung cancer screening (LCS) that may exclude large numbers of high-risk African American smokers, revised U.S. Preventive Services Task Force (USPSTF) recommendations lowered LCS eligibility thresholds. However, there are limited recent data about the impact of newly revised guidelines on disparities in LCS eligibility.Purpose: To evaluate the impact of revised USPSTF guidelines on racial and ethnic disparities in LCS eligibility. Materials and Methods:Cross-sectional survey data from 20 states were retrospectively evaluated from the 2019 Behavioral Risk Factor Surveillance System survey (median response rate, 49.4%). Respondents without a history of lung cancer aged 55-79 years (ie, under the previous guidelines) or aged 50-79 years (ie, under the revised guidelines) were included. Multivariable logistic regression analyses were performed to evaluate the association between race and ethnicity and LCS eligibility. All analyses were performed accounting for complex survey design features (ie, weighting, stratification, and clustering). Results: Under previous guidelines, 11% of 67 567 weighted survey respondents were eligible for...

show abstract

Section: Discussionmentioning

confidence: 99%

Racial and Ethnic Disparities in Lung Cancer Screening Eligibility

et al. 2021

View full text Add to dashboard Cite

show abstract

“…A survey of 112 adults with schizophrenia revealed that 88% had seen a primary care provider within the past year in addition to monthly visits with a psychiatrist, 34% met the high-risk criteria for lung cancer screening, yet only half of the current smokers were advised to quit, one-third were offered assistance with smoking cessation, and 13% were referred for smoking cessation counseling (34). Transgender individuals also have a disproportionate higher risk of lung cancer, and data from their responses in the BRFSS were analyzed (35). Only 2.3% of transgender participants reported undergoing screening compared with 17.2% of cisgender participants despite similar eligibility.…”

Section: System-related Barriersmentioning

confidence: 99%

A narrative review of lung cancer screening implementation: increasing utilization of evidence-based practice

Miller¹,

Haren²

2023

Curr Chall Thorac Surg

View full text Add to dashboard Cite

Cancer is the second leading cause of death in the United States, with lung cancer causing more cancer deaths annually than any other primary site. The high mortality is, in part, due to the lack of symptoms during early stage disease. There is therefore a resultant delay in diagnosis until lung cancer has progressed to later stages, when fewer if any potentially curative options exist. Low-dose computed tomography (LDCT) scanning for screening of high-risk patients has been found to identify lung cancer at earlier stages, and this has corresponded both with an increase in curative intervention and a decrease in lung cancer mortality. Although lung cancer screening carries a relatively low risk of harm, it remains underutilized. The rates of eligible patients that undergo lung cancer screening varies regionally, with rates of screening ranging from less than 4% of eligible patients up to 18% in some states. This low rate of screening has persisted over the past few years despite recommendations for lung cancer screening from national and international organizations. Improving utilization rates requires identification of barriers to screening and strategies to resolve these barriers. As screening utilization rates increase, continued improvement in rates of early diagnosis and mortality from lung cancer would then be expected to follow.

show abstract

“…Like racial or ethnic minority populations, gender minority populations also face their own unique barriers to lung cancer screening. Transgender persons are less likely to receive lung cancer screening despite having similar smoking status and eligibility to cisgender persons because of an existing disparity in utilization of this screening service [62]. In addition, gay men and lesbian women were four to five times more likely to be eligible for lung cancer screening compared with their heterosexual counterparts, but they were no more likely to have undergone lung cancer screening [63].…”

Section: Lung Cancer Screeningmentioning

confidence: 99%

Health Care Disparities in Radiology—A Review of the Current Literature

DeBenedectis¹,

Spalluto²,

Americo³

et al. 2022

Journal of the American College of Radiology

View full text Add to dashboard Cite

Introduction: Health care disparities exist in all medical specialties, including radiology. Raising awareness of established health care disparities is a critical component of radiology's efforts to mitigate disparities. Our primary objective is to perform a comprehensive review of the last 10 years of literature pertaining to disparities in radiology care. Our secondary objective is to raise awareness of disparities in radiology.Methods: We reviewed English-language medicine and health services literature from the past 10 years (2010-2020) for research that described disparities in any aspect of radiologic imaging using radiology search terms and key words for disparities in OVID. Relevant studies were identified with adherence to the guidelines set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results:The search yielded a total 1,890 articles. We reviewed the citations and abstracts with the initial search yielding 1,890 articles (without duplicates). Of these, 1,776 were excluded based on the criteria set forth in the methods. The remaining unique 114 articles were included for qualitative synthesis.Discussion: We hope this article increases awareness and inspires action to address disparities and encourages research that further investigates previously identified disparities and explores not-yet-identified disparities.

show abstract

Lung Cancer Screening Eligibility and Utilization Among Transgender Patients: An Analysis of the 2017–2018 United States Behavioral Risk Factor Surveillance System Survey

Cited by 17 publications

References 29 publications

Racial and Ethnic Disparities in Lung Cancer Screening Eligibility

Racial and Ethnic Disparities in Lung Cancer Screening Eligibility

A narrative review of lung cancer screening implementation: increasing utilization of evidence-based practice

Health Care Disparities in Radiology—A Review of the Current Literature

Contact Info

Product

Resources

About