Department of Radiology
University of Wisconsin School of Medicine and Public Health

Lake 2020

 

Year: 2020

Title: Black patients referred to a lung cancer screening program experience lower rates of screening and longer time to follow-up

Country: United States

Age: Adult Only

Sex: All Sexes

Population: Black

Care Setting: Outpatient Ambulatory and Primary Care

Clinical Setting: Lung Cancer Screening

Data Level: Single Institution

Data Type: Disease Registry

Data Source: Jane and Leonard Korman Respiratory Institute Lung Cancer Screening Program

Conclusion: Disparities In All Minority Groups

Health OutComes Reported: No

Mitigation: No

Free Text Conclusion: Black patients referred for lung cancer screening had lower odds of receiving a low-dose CT than White patients.

Abstract: Background: Racial disparities are well-documented in preventive cancer care, but they have not been fully explored in the context of lung cancer screening. We sought to explore racial differences in lung cancer screening outcomes within a lung cancer screening program (LCSP) at our urban academic medical center including differences in baseline low-dose computed tomography (LDCT) results, time to follow-up, adherence, as well as return to annual screening after additional imaging, loss to follow-up, and cancer diagnoses in patients with positive baseline scans. Methods: A historical cohort study of patients referred to our LCSP was conducted to extract demographic and clinical characteristics, smoking history, and lung cancer screening outcomes. Results: After referral to the LCSP, blacks had significantly lower odds of receiving LDCT compared to whites, even while controlling for individual lung cancer risk factors and neighborhood-level factors. Blacks also demonstrated a trend toward delayed follow-up, decreased adherence, and loss to follow-up across all Lung-RADS categories. Conclusions: Overall, lung cancer screening annual adherence rates were low, regardless of race, highlighting the need for increased patient education and outreach. Furthermore, the disparities in race we identified encourage further research with the purpose of creating culturally competent and inclusive LCSPs.