MINI01.10: Diverse Populations may be Underrepresented in Community Lung Cancer Screening Programs Topic: Pulmonology

Publication Title

Journal of Thoracic Oncology

Document Type

Conference Proceeding

Publication Date

11-2016

Keywords

washington; swedish; swedish thoracic surgery; diversity

Abstract

Background

The National Lung Screening Trial (NLST), a multi-center, mostly urban study, showed a 20% reduction in mortality from lung cancer through screening. However, participants in the NLST were 59% male and 91% white, a demographic unrepresentative of the general smoking population. In response to this data, we sought to examine the demographics of the Lung Cancer Screening Program (LCSP) at Swedish Cancer Institute (SCI) and compare them to state demographics to ensure that this valuable resource is being equitably accessed.

Methods

We reviewed individuals referred to the LCSP at SCI, an urban community teaching hospital, from 2012-2016 at two separate screening sites in King County, Washington. Each individual’s demographic information was collected from their Electronic Medical Record and median household income was calculated using their zip code. Demographics of the Washington smoking population from the Department of Health (DOH) were used as an unmatched comparative “high risk” population.

Results

We identified 634 individuals referred for Lung Cancer Screening (LCS). Of these, 53% were male and 79% were white with a median income of $67,705. DOH statistics show that among Washington State current smokers, American Indian/Alaska Natives have the highest smoking prevalence, along with those with income <$35,000. Of individuals referred to SCI LCSP, only 1.3% were American Indian/ Alaska Native and only 1.4% had income <$35,000. Individuals referred for LCS were most often covered by private insurance (37.8%) with 20.5% covered by Medicare alone and 10.6% covered by Medicaid.

Conclusion

We have identified the potential for lack of diversity in patients referred for LCS in Washington State. A better understanding of the demographic composition of the high risk populations we seek to serve, along with targeted efforts to increase access and awareness, will be required to reduce barriers to LCS.

Article info

Clinical Institute

Cancer

Specialty

Oncology

Specialty

Pulmonary Medicine

Specialty

Population Health

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