Racial Differences in Lung Cancer Screening Beliefs and Screening Adherence

Barta, Julie A.; Shusted, C.S.; Ruane, Brooke; Pimpinelli, Marcella; McIntire, Russell K.; Zeigler‐Johnson, Charnita; Myers, Ronald E.; Evans, Nathaniel R.; Kane, Gregory C.; Juon, Hee‐Soon

doi:10.1016/j.cllc.2021.06.003

Cited by 17 publications

(15 citation statements)

References 48 publications

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“…Screening adherence was determined using modi ed National Lung Cancer Roundtable (NLCRT) de nitions. (9,24) For individuals due for annual screening, a return date of 12 months rather than 18 months was used due to the timeframe of the study period. For individuals with Lung-RADS Category 3 or 4A results, the NLCRT quality metric de nitions were followed.…”

Section: Discussionmentioning

confidence: 99%

Individual- and Neighborhood-Level Characteristics of Lung Cancer Screening Participants Undergoing Telemedicine Shared Decision Making

Shusted

Juon

Ruane

et al. 2023

Preprint

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Background: Although lung cancer screening (LCS) for high-risk individuals reduces lung cancer mortality in clinical trial settings, many questions remain about how to implement high-quality LCS in real-world programs. With the increasing use of telemedicine in healthcare, studies examining this approach in the context of LCS are urgently needed. We aimed to identify sociodemographic and other factors associated with screening completion among individuals undergoing telemedicine LCS. Methods: This retrospective study examined patients who completed Shared Decision Making (SDM) via telemedicine between May 4, 2020 – March 18, 2021 in a centralized LCS program. Individuals were categorized into Complete Screening vs. Incomplete Screening subgroups based on the status of subsequent LDCT completion. A multi-level, multivariate model was constructed to identify factors associated with incomplete screening. Results: Among individuals undergoing telemedicine SDM during the study period, 20.6% did not complete a LDCT scan. Bivariate analysis demonstrated that Black/African-American race, Medicaid insurance status, and new patient type were associated with greater odds of incomplete screening. On multi-level, multivariate analysis, individuals who were new patients undergoing baseline LDCT or resided in a census tract with a high level of socioeconomic deprivation had significantly higher odds of incomplete screening. Individuals with a greater level of education experienced lower odds of incomplete screening. Conclusions: Among high-risk individuals undergoing telemedicine SDM for LCS, predictors of incomplete screening included low education, high neighborhood-level deprivation, and new patient type. Future research should focus on testing implementation strategies to improve LDCT completion rates while leveraging telemedicine for high-quality LCS.

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Section: Discussionmentioning

confidence: 99%

Individual- and Neighborhood-Level Characteristics of Lung Cancer Screening Participants Undergoing Telemedicine Shared Decision Making

Shusted

Juon

Ruane

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

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“…Although this finding is not new, few advances have been made in mitigating the disparity 11 . Prior work has also shown that Black individuals more frequently cite concern about screening convenience and cost of LCS than non‐Hispanic white individuals 12 …”

Section: Introductionmentioning

confidence: 98%

“… 11 Prior work has also shown that Black individuals more frequently cite concern about screening convenience and cost of LCS than non‐Hispanic white individuals. 12 …”

Section: Introductionmentioning

confidence: 99%

“… 13 Similarly, one study found that Black individuals who had attained more than a high school education had a higher likelihood of adhering to annual LCS than non‐Hispanic White individuals who had less than a high school education. 12 …”

Section: Introductionmentioning

confidence: 99%

“…For instance, there are differences in adherence to annual LCS, with lower adherence observed in certain groups including individuals who currently smoke, have less than a college education, individuals who are racial minorities, and those who are less than 65 years old 13 . Similarly, one study found that Black individuals who had attained more than a high school education had a higher likelihood of adhering to annual LCS than non‐Hispanic White individuals who had less than a high school education 12 …”

Section: Introductionmentioning

confidence: 99%

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Impact of U.S. Preventive Services Task Force lung cancer screening update on drivers of disparities in screening eligibility

et al. 2022

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Background:In 2021, the U.S. Preventive Services Task Force (USPSTF) updated its recommendation to expand lung cancer screening (LCS) eligibility and mitigate disparities. Although this increased the number of non-White individuals who are eligible for LCS, the update's impact on drivers of disparities is less clear. This analysis focuses on racial disparities among Black individuals because members of this group disproportionately share late-stage lung cancer diagnoses, despite typically having a lower intensity smoking history compared to non-Hispanic White individuals. Methods:We used data from the National Health Interview Survey to examine the impact of the 2021 eligibility criteria on racial disparities by factors such as education, poverty, employment history, and insurance status. We also examined preventive care use and reasons for delaying medical care.Results: When comparing Black individuals and non-Hispanic White individuals, our analyses show significant differences in who would be eligible for LCS: Those who do not have a high school diploma (28.7% vs. 17.0%, p = 0.002), are in poverty (26.2% vs. 14.9%, p < 0.001), and have not worked in the past 12 months (66.5% vs. 53.9%, p = 0.009). Further, our analyses also show that more Black individuals delayed medical care due to not having transportation (11.1% vs. 3.6%, p < 0.001) compared to non-Hispanic White individuals. Conclusions:Our results suggest that despite increasing the number of Black individuals who are eligible for LCS, the 2021 USPSTF recommendation highlights ongoing socioeconomic disparities that need to be addressed to ensure equitable access.

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Participant factors associated with psychosocial impacts of lung cancer screening: A systematic review

McFadden,

Nickel,

Rankin

et al. 2024

Cancer Medicine

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BackgroundPsychosocial impacts of lung cancer screening (LCS) can cause both harm to individuals and serve as barriers to screening participation and adherence. Early data suggest that the psychosocial impacts of LCS are moderated by certain factors (e.g. sociodemographic characteristics and beliefs), but evidence synthesis is lacking. This systematic review aimed to understand individual‐level risk factors for psychosocial burden during LCS as a precursor to developing strategies to identify and support participants, and improve LCS engagement.MethodsFour databases were searched for full‐text articles published in English reporting any association between participant factors and psychosocial outcomes experienced during LCS. Study quality was assessed by two independent investigators; findings were synthesised narratively. The review was pre‐registered with PROSPERO and adhered to PRISMA guidelines.ResultsThirty‐five articles were included; most (33/35) studies were assessed at high or moderate risk of bias. Study designs were pre‐post (n = 13), cross‐sectional (n = 13), qualitative (n = 8) and mixed‐methods (n = 1) and conducted primarily in the United States (n = 17). Psychological burden in LCS varied, and was often associated with younger age, female gender, current smoking status or increased smoking history, lower education, lower socio‐economic group, not being married or co‐habiting and experience with cancer. However, results were mixed, and non‐significant associations were also reported across all factors. Beliefs (e.g. fatalism, stigma and expectation of LDCT results) and comorbid psychological burden were also linked to psychosocial outcomes, but evidence was sparse. Associations between risk perception, other participant factors and other psychosocial outcomes was inconclusive, likely reflecting individual biases in risk conceptualisation.Conclusion(s)Several participant factors are consistently reported to be associated with psychosocial impacts of LCS, though study heterogeneity and high risk of bias necessitate more robust evaluation. Further research on how perceptions, beliefs and expectations can be used to improve psychosocial outcomes during LCS is needed.

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Racial Differences in Lung Cancer Screening Beliefs and Screening Adherence

Cited by 17 publications

References 48 publications

Individual- and Neighborhood-Level Characteristics of Lung Cancer Screening Participants Undergoing Telemedicine Shared Decision Making

Individual- and Neighborhood-Level Characteristics of Lung Cancer Screening Participants Undergoing Telemedicine Shared Decision Making

Impact of U.S. Preventive Services Task Force lung cancer screening update on drivers of disparities in screening eligibility

Participant factors associated with psychosocial impacts of lung cancer screening: A systematic review

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