Abstract C113: Geographic variation in low-dose computed tomography scanning for lung cancer screening in the United States

Abstract

Abstract Background: Early detection using low-dose computed tomography scanning reduces lung cancer specific mortality by 20%. Despite its efficacy and its recommendation by the United States Preventive Services Task Force, the uptake of lung cancer screening (LCS) among high-risk individuals (aged 55–80 years with a >30-pack-year smoking history and who currently smoke or have quit within the previous 15 years) remains low. The purpose of this study was to assess whether LCS uptake varies by geographic location. Methods: Data for this study were obtained from the 2019 Behavioral Risk Factor Surveillance System. After excluding ineligible subjects, 10,242 subjects were included in the final analysis. Multivariable logistic regression models were used to model the associations between the predictor and the outcome variable, adjusting for potential confounders. Results: In metropolitan statistical areas, individuals who reside outside the center city are less likely to receive LCS than those who reside in the center city (OR: 0.65; 95% CI: 0.43 – 0.98). Stratifying the data by race/ethnicity, we found a non-significant difference between Whites who reside in the center city and those outside the center city in LCS uptake (OR: 0.69; 95% CI: 0.45 – 1.06). Among Blacks (OR:0.10; 95% CI: 0.02 – 0.59) and other minorities (OR:0.10; 95% CI: 0.02 – 0.63), individuals who reside outside the center city are less likely to receive LCS than their respective counterparts residing in the center city. Nevertheless, we found a non-significant difference in LCS uptake between urban and rural counties (OR: 1.06; 95% CI: 0.76-1.48).Conclusions: LCS uptake is related to metropolitan statistical area (residents in the center city vs. outside the center city), but it is modified by race/ethnicity. This finding has important implications for policy makers and program planners in helping them design more effective interventions to promote LCS targeting racial/ethnic minorities residing outside the center city. Citation Format: Abdi T. Gudina, Lee A. Kehoe, Sara Hardy, Charles S. Kamen, Paula Cupertino. Geographic variation in low-dose computed tomography scanning for lung cancer screening in the United States [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C113.