Black patients referred to a lung cancer screening program experience lower rates of screening and longer time to follow-up
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 ac...
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doaj-1b93767f7e544d68991bfa6a2b5ffd692020-11-25T03:08:22ZengBMCBMC Cancer1471-24072020-06-0120111210.1186/s12885-020-06923-0Black patients referred to a lung cancer screening program experience lower rates of screening and longer time to follow-upMichael Lake0Christine S. Shusted1Hee-Soon Juon2Russell K. McIntire3Charnita Zeigler-Johnson4Nathaniel R. Evans5Gregory C. Kane6Julie A. Barta7The Jane and Leonard Korman Respiratory Institute, Division of Pulmonary and Critical Care MedicineThe Jane and Leonard Korman Respiratory Institute, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Sidney Kimmel Medical College at Thomas Jefferson UniversityDepartment of Medical Oncology, Division of Population Science, Thomas Jefferson UniversityJefferson College of Population Health, Thomas Jefferson UniversityDepartment of Medical Oncology, Division of Population Science, Thomas Jefferson UniversityThe Jane and Leonard Korman Respiratory Institute, Department of Surgery, Division of Thoracic SurgeryThe Jane and Leonard Korman Respiratory Institute, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Sidney Kimmel Medical College at Thomas Jefferson UniversityThe Jane and Leonard Korman Respiratory Institute, Division of Pulmonary and Critical Care MedicineAbstract 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.http://link.springer.com/article/10.1186/s12885-020-06923-0Lung Cancer ScreeningRacial disparitiesLung CancerCancer ScreeningLung Cancer diagnosisScreening adherence |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Michael Lake Christine S. Shusted Hee-Soon Juon Russell K. McIntire Charnita Zeigler-Johnson Nathaniel R. Evans Gregory C. Kane Julie A. Barta |
spellingShingle |
Michael Lake Christine S. Shusted Hee-Soon Juon Russell K. McIntire Charnita Zeigler-Johnson Nathaniel R. Evans Gregory C. Kane Julie A. Barta Black patients referred to a lung cancer screening program experience lower rates of screening and longer time to follow-up BMC Cancer Lung Cancer Screening Racial disparities Lung Cancer Cancer Screening Lung Cancer diagnosis Screening adherence |
author_facet |
Michael Lake Christine S. Shusted Hee-Soon Juon Russell K. McIntire Charnita Zeigler-Johnson Nathaniel R. Evans Gregory C. Kane Julie A. Barta |
author_sort |
Michael Lake |
title |
Black patients referred to a lung cancer screening program experience lower rates of screening and longer time to follow-up |
title_short |
Black patients referred to a lung cancer screening program experience lower rates of screening and longer time to follow-up |
title_full |
Black patients referred to a lung cancer screening program experience lower rates of screening and longer time to follow-up |
title_fullStr |
Black patients referred to a lung cancer screening program experience lower rates of screening and longer time to follow-up |
title_full_unstemmed |
Black patients referred to a lung cancer screening program experience lower rates of screening and longer time to follow-up |
title_sort |
black patients referred to a lung cancer screening program experience lower rates of screening and longer time to follow-up |
publisher |
BMC |
series |
BMC Cancer |
issn |
1471-2407 |
publishDate |
2020-06-01 |
description |
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. |
topic |
Lung Cancer Screening Racial disparities Lung Cancer Cancer Screening Lung Cancer diagnosis Screening adherence |
url |
http://link.springer.com/article/10.1186/s12885-020-06923-0 |
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