Lung cancer screening in the prison population.

Abstract

114 Background: The United States incarcerated population is large and aging resulting in greater incidence of cancer. Inmates are a vulnerable population with increased rates of tobacco use that can place them at risk of developing lung cancer. The goal of this study is to determine whether inmates within the Connecticut (CT) Department of Corrections (DOC) with a history of smoking are screened for lung cancer and to implement a process by which they may be screened. Methods: We conducted a retrospective chart review of patients within the CT DOC that have been diagnosed with a lung nodule or lung mass between the years 2018-2021. Each chart was reviewed to determine if these patients met the current United States Preventative Service Task Force (USPSTF) guidelines for lung cancer screening with low dose CT scan (LDCT). After identifying an opportunity for improvement, we then implemented a shared decision-making clinic to screen inmates. Patients were scheduled for LDCT if they met eligibility criteria and consented to CT scan. Results: 28 patients of charts reviewed were identified as eligible for LDCT screening from the years of 2018-2021. These results showed that 9 (32%) patients out of 28 had LDCT completed. 7 (25%) of these patients had biopsy proven lung cancer. 300 inmates residing within the CTDOC were found to have a significant smoking history. Thus far, 11 patients have been evaluated in our shared decision-making clinic. 7 patients met criteria for LDCT and underwent CT scan. All 7 patients require annual follow up for 3 years. 1 patient declined meeting with our providers. We will continue to offer screening to all eligible and consenting inmates. Conclusions: Through our study we have identified a need to improve screening for lung cancer in the DOC population. We have implemented a process by which inmates can be screened with help from our DOC, Pulmonology, and Radiology colleagues. We will continue the current process to screen and obtain consent for the 300 inmates identified as having a significant smoking history. To our best knowledge, this is the first study that demonstrates a sustainable workflow to screen DOC inmates for lung cancer.