P1.03-051 Medically Underserved and Geographically Remote Individuals May Be Underrepresented in Current Lung Cancer Screening Programs Topic: Screening

Publication Title

Journal of Thoracic Oncology

Document Type

Conference Proceeding

Publication Date

1-2017

Keywords

washington; swedish; swedish thoracic surgery; diversity

Abstract

Background

The National Lung Screening Trial demonstrated a 20% reduction in lung cancer mortality and ushered in lung cancer screening (LCS). Study centers included 33 academic, mostly urban-based sites, which may underrepresent low socioeconomic remote populations with minimal health care access. United States Census Bureau 2014 data demonstrated that smoking is concentrated among adults with low income and education, and without private medical insurance; components of medically underserved/shortage area designations. We sought to assess the representation of underserved communities in our hospital-based Lung Cancer Screening Program (LCSP).

Methods

We reviewed individuals referred to our LCSP from 2012-2016, consisting of two separate screening sites located within metropolitan King County, Washington. Each individual’s county and distance from the LCS site was calculated. Individual’s residence designation as a geographic medically underserved/shortage area was determined. Definitions include: medically underserved area [MUA; healthcare resources deficient region], medically underserved population [MUP; area with economic/cultural/linguistic barriers to primary care services], health professional shortage area [HPSA; primary care physician shortage].

Results

We identified 599 referred individuals, median age 64, from 13/39 counties (King County and 12 clustered, surrounding counties). Overall, <20% of the referred population resided in underserved/shortage areas and <55% of the designated geographic underserved/shortage areas in the 13 counties had patient referrals (Table). Of those referred, 85% resided in King County, 17% in a MUA and 65% of the MUAs had patient referrals. Two percent of the referral population resided in a remote county, Clallam, where ≥70% of referred households were in underserved/shortage areas.

Conclusion

The majority of individuals referred reside within 10 miles of the LCS site. Less than 20% reside in designated underserved/shortage areas and <55% of underserved/shortage areas are represented. Creative and coordinated approaches, like Telemedicine, will be required to address the potential lack of LCS services in underserved/shortage areas and facilitate individuals remaining in their communities.

Keywords

lung cancer screening, Medically underserved area/population, Health professional shortage area, Geographically remote

Clinical Institute

Cancer

Specialty

Oncology

Specialty

Pulmonary Medicine

Specialty

Population Health

Link to Full Text


Share

COinS