Abstract 4790: Hospitalization as an opportunity to improve lung cancer screening in high-risk patients

Abstract

Abstract Background: Lung cancer screening with annual low-dose computed tomography (LDCT) in high-risk patients with exposure to smoking reduces lung cancer-related mortality, yet the screening rate of eligible adults is low. As hospitalization is a critical moment to engage patients in their overall health, it may be an opportunity to improve rates of lung cancer screening. Prior to implementing a hospital-based lung cancer screening referral program, this study assesses the association between hospitalization and completion of lung cancer screening. Methods: A retrospective cohort study of evaluated completion of at least one LDCT from 2014-2021 using electronic health record data using hospitalization as the primary exposure. Patients aged 55-80 who received care from a university-based internal medicine clinic and reported cigarette use were included. Univariate analysis and logistic regression models evaluated the association of hospitalization and completion of LDCT. The secondary outcome was completion of any CT of the chest. Results: Of the 1,935 current smokers identified, 47% had at least one hospitalization, and 21% completed a LDCT during the study period. While a higher proportion of patients with a hospitalization had a LDCT (24%) compared to patients without a hospitalization (18%, p<0.001), there was no association between hospitalization and completion of a LDCT after adjusting for potentially confounding covariates (95%CI 0.680 - 1.149). Of cohort patients, 38% completed any CT of the chest and hospitalization was associated with increased odds of receiving chest CT imaging in the adjusted model (OR 1.72; 95%CI 1.37 - 2.17). Conclusions: In a cohort of patients at risk for lung cancer, only 1 in 5 completed lung cancer screening with LDCT and hospitalization events were not associated with LDCT completion. A hospitalist driven lung cancer screening program has the potential to increase the suboptimal rates of lung cancer screening in high-risk patients. Citation Format: Ellen M. Nielsen, Jingwen Zhang, Justin Marsden, Chloe Bays, William P. Moran, Patrick D. Mauldin, Leslie A. Lenert, Benjamin A. Toll, Andrew D. Schreiner, Marc Heincelman. Hospitalization as an opportunity to improve lung cancer screening in high-risk patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4790.