Descriptive cross-sectional analysis of lung cancer screening in inner city resident run clinic.

Abstract

e18668 Background: Lung cancer is one of the leading causes of cancer-related morbidity and mortality. The 5-year survival rate is 19% but goes up to 57% if diagnosed at early stage. The recommendation for lung cancer screening is low-dose computed tomography (LDCT) for adults of age 55 to 80 years who have a 30 pack-year smoking history and are currently smoking or have quit in the past 15 years. Unfortunately, less than 5% of eligible patients undergo LDCT. Methods: A retrospective chart review was done for patients with any smoking history, who had internal medicine residents as their primary care provider. The data collected included baseline characteristics and the rates of LDCT scan being ordered and completed. Results: 706 medical charts were reviewed. 178 patients (25.2%) qualified for LDCT screening. The average age of patients included was 64.41 years and average BMI was 28.8 kg/m2. 48.3% were female and 51.6% were male. 54% were current smokers and 46% were former smokers. The ethnic/racial distribution was as follows: 19% African American, 36.5% Hispanic,16.2% Caucasian and 27.5% belonging to other groups. The primary insurance was as follows: 48.8% Medicaid, 19.6% Medicare, 25.8% private insurance and 5% were uninsured. 95 patients (53.3%) had a LDCT scan ordered and 73/95 (76.8%) completed the LDCT scan. The rate of compliance among patients based on their race/ethnicity and primary insurance is detailed in the table. Only 30% of the patients initially screened had a follow up LDCT ordered in one year. Conclusions: Low screening rate LDCT may be due to new residents not prioritizing preventative care. Patients at this clinic belong to a lower socioeconomic class with limited resources. There may be barriers to completion of the ordered test, like poor health literacy, scheduling issues, transportation, fear of being diagnosed with cancer and poor understanding of preventative health. Residents need to be educated about the importance of lung cancer screening as early detection translates into better outcomes and lower mortality. Patients need to be informed of the benefit of screening to improve compliance rate. Assessing the barriers these patients face to completing the screening test should also be carefully evaluated to better identify areas of improvement.[Table: see text]