Lung Cancer Screening Eligibility and Uptake by Lung Cancer Risk in Black and White Patients in Two Health Care Systems
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Walaska, Kristen
Friedman, Elena
Balletto, Brittany
Cameron, Sarah
Tanzer, Joshua Ray
Fang, Pearl
Clark, Melissa
Fava, Joseph
Busch, Andrew
Breault, Christopher
Rosen, Rochelle
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Abstract
PURPOSE: Annual low dose Computed Tomography (CT) scans for lung cancer screening (LCS) among high risk individuals reduce lung cancer mortality. Despite this, LCS is underutilized. Black people who use tobacco have high risk of lung cancer but have been underserved for screening. The current study reports LCS eligibility based on the 2013 and 2021 USPSTF guidelines compared to the PLCOm2012 lung cancer risk calculator and examines lung cancer screening eligibility, referral and uptake among patients by race.
METHODS: We invited 3000 patients aged 55-80 with a smoking history (oversampled for Black patients) across two healthcare systems to participate in a survey. The survey assessed lung cancer risk; eligibility, referral and receipt of LCS.
RESULTS: 1177 participants completed the survey (45% White, 39% Black; 42% response rate). Of these, 23.6% met USPSTF2013 criteria and 30.7% met USPSTF2021 criteria. White patients were more likely than Black patients to be recommended for LCS with USPSTF2013 but not USPSTF2021 guidelines. USPSTF2021 guidelines recommended LCS for more patients including more low risk patients. About a third of patients eligible for LCS reported a doctor recommended screening, compared to 90% of eligible patients receiving a doctor recommendation for colorectal cancer screening. Black patients were less likely to complete lung cancer screening when referred compared to White patients.
CONCLUSIONS: New LCS guidelines ameliorated racial disparities (White vs. Black) in eligibility, but screen more low risk individuals. Physician recommendations for LCS but not colorectal cancer screening are far below guidelines.
CLINICAL IMPLICATIONS: System changes are needed to improve provider referral for LCS and to assist eligible Black patients in receiving LCS.
DISCLOSURES:
No relevant relationships by Brittany Balletto
No relevant relationships by Christopher Breault
No relevant relationships by Andrew Busch
No disclosure on file for Sarah Cameron
No relevant relationships by Melissa Clark
No disclosure on file for Pearl Fang
No relevant relationships by Joseph Fava
Employee relationship with Medtronic Please note: 3/7/2023 to present Added 03/15/2023 by Elena Friedman, source=Web Response, value=Salary
No relevant relationships by Sandra Japuntich
No relevant relationships by Rochelle Rosen
No relevant relationships by Joshua Ray Tanzer
No relevant relationships by Kristen Walaska
Journal Title
Chest
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CHEST 2023 Annual Meeting Abstracts
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164
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4
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Cardiovascular medicine and haematology
Clinical sciences
Science & Technology
Life Sciences & Biomedicine
Critical Care Medicine
Respiratory System
General & Internal Medicine
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Japuntich, S; Walaska, K; Friedman, E; Balletto, B; Cameron, S; Tanzer, JR; Fang, P; Clark, M; Fava, J; Busch, A; Breault, C; Rosen, R, Lung Cancer Screening Eligibility and Uptake by Lung Cancer Risk in Black and White Patients in Two Health Care Systems, Chest, 2023, 164 (4), pp. 4133A