Abstract A086: Disparities in lung cancer screening uptake across the United States
Authors: Gudina Abdi , Rivera M. Patricia , Kamen Charles , Cupertino AnaPaula 
Published: January 2023

Abstract
Background: Despite the efficacy of low-dose computerized tomography (LDCT) to detect lung cancer early, the rate of lung cancer screening among high-risk individuals remains low. The purpose of this study was to assess lung cancer screening rates in contrast with state lung cancer mortality across the United States. Methods: Data for this study were obtained from the Behavioral Risk Factor Surveillance System (BRFSS) from three consecutive years (2018-2020); a population-based survey administered via cell phone and landline and conducted annually by the Centers for Disease Control and Prevention (CDC). Eligibility criteria follow the 2013 U.S. Preventive Services Task Force (USPSTF) recommendation: high-risk individuals aged 55-80 years with a &gt;30 pack-year smoking history who currently smoke or have quit within the past 15 years. After excluding ineligible subjects and those with missing information, 11,297 subjects were included in the final analysis. Multivariable logistic regression models were used to assess the association between the predictor (i.e., state of residence) and the outcome variable (i.e., screening rate). Results: Of the 24 states included in this study, the states with the highest lung cancer screening rates were Rhode Island (24.75%), Vermont (22.51%), New Jersey (21.72%), Minnesota (21.64%), and Delaware (21.39%). The states with the lowest screening uptake were Oklahoma (9.23%), Utah (9.78%), West Virginia (12.23%), South Dakota (12.31%), and Kansas (12.41%). Kentucky has the highest lung cancer mortality and has become the 6th highest in screening rates. Utah has the lowest lung cancer mortality and is the second-lowest state in lung cancer screening rates. After adjusting for sociodemographic (i.e., age, gender, marital status, level of education, income, insurance, and race/ethnicity) and health-related factors (i.e., chronic obstructive pulmonary disease, smoking history, and primary care provider), high-risk individuals in the state of Delaware (OR: 2.85, 95% CI: 1.50 - 5.41), Kentucky (OR: 2.04, 95% CI: 1.03 - 4.04), Minnesota (OR: 2.74, 95% CI: 1.49 - 5.06), Montana (OR: 2.15, 95% CI: 1.09 - 4.25), New Jersey (OR: 2.39, 95% CI: 1.25 - 4.57), Pennsylvania (OR: 2.28, 95% CI: 1.17 - 4.44), Rhode Island (OR: 2.57, 95% CI: 1.33 - 4.98), Texas (OR: 4.51, 95% CI: 2.04 - 9.97) and Vermont (OR: 3.18, 95% CI: 1.61 - 6.28) were significantly more likely to receive lung cancer screening than those in Utah. High-risk individuals in all the remaining states were not significantly different in terms of their lung cancer screening rates compared to Utah. Conclusions: Lung cancer screening rates varied widely across 24 states and did not match with the lung cancer mortality burden in each state. The results from the present study highlights the importance of developing targeted initiatives and policies that enhance the rates of lung cancer screenings in the states that experience a disproportionate burden of lung cancer mortality.
Citation Format: Abdi Gudina, M. Patricia Rivera, Charles Kamen, AnaPaula Cupertino. Disparities in lung cancer screening uptake across the United States [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A086.