ASPO Abstracts
Geographic Disparities in Lung Cancer Screening in the U.S.
Category: Cancer Health Disparities
Conference Year: 2019
Abstract Body:
Purpose — The purpose of this study is to highlight geographic differences in eligibility for and utilization of low-dose computed tomography (LDCT) screening for lung cancer in the United States (U.S.)Methods - We used data from the 2015 National Health Interview Survey (NHIS), a population-based national survey disseminated by the CDC, to identify geographic differences in LDCT screening eligibility and utilization. We used a series of questions related to smoking history and screening utilization to define LDCT screening eligibility by the 2013 USPSTF guidelines: current or former smoker who quit within the past 15 years, ages 55-80, and ≥30 pack-year smoking history. We used Urban Influence Codes developed by the US Department of Agriculture to designate all counties in the U.S. as urban (metropolitan) or micropolitan/rural. Results - We found that 77% of the LDCT screening eligible population in 2015 lived in urban areas, while 23% lived in micropolitan/rural areas. Despite more screening centers located in urban areas, we found lung cancer screening uptake was not significantly different between urban (3.89%) and micropolitan/rural residents (3.72%). When compared by U.S. Census regions, over 40% of the screening eligible population lived in the South followed by 26.16% in the Midwest, 17.88% in the West, and 15.51% in the Northeast. The Northeast had the lowest share of the screening eligible population but had the highest screening utilization at 10.11% (South: 3.51%, Midwest: 2.18%; West: 1.58%). Conclusions - Our descriptive analysis showed significant geographic disparities in LDCT screening uptake. Despite having the smallest share of LDCT-screening eligible individuals, uptake in the Northeast was 3-5 times higher than other Census regions. Our presented descriptive analysis is the only population-based assessment of LDCT screening uptake among rural populations. Up-to-date and geographically comprehensive surveillance data can inform cancer control efforts. Population-based surveys should be enhanced to better surveil the uptake of LDCT screening across geographies. This is especially important for lung cancer which has notable rural-urban and regional disparities.
Keywords: Lung Cancer, Rural, Early Detection