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Hong YR, Wheeler M, Wang R, Karanth S, Yoon HS, Meza R, Kaye F, Bian J, Jeon J, Gould MK, Braithwaite D. Patient-Provider Discussion About Lung Cancer Screening by Race and Ethnicity: Implications for Equitable Uptake of Lung Cancer Screening. Clin Lung Cancer 2024; 25:39-49. [PMID: 37673782 DOI: 10.1016/j.cllc.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 08/10/2023] [Accepted: 08/14/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Physician-patient discussions regarding lung cancer screening (LCS) are uncommon and its racial and ethnic disparities are under-investigated. We examined the racial and ethnic disparities in the trends and frequency of LCS discussion among the LCS-eligible United States (US) population. METHODS We analyzed data from the Health Information National Trends Survey from 2014 to 2020. LCS-eligible individuals were defined as adults aged 55 to 80 years old who have a current or former smoking history. We estimated the trends and frequency of LCS discussions and adjusted the probability of having an LCS discussion by racial and ethnic groups. RESULTS Among 2136 LCS-eligible participants (representing 22.7 million US adults), 12.9% (95% CI, 10.9%-15%) reported discussing LCS with their providers in the past year. The frequency of LCS discussion was lowest among non-Hispanic White participants (12.3%, 95% CI, 9.9%-14.7%) compared to other racial and ethnic groups (14.1% in Hispanic to 15.3% in non-Hispanic Black). A significant increase over time was only observed among non-Hispanic Black participants (10.1% in 2014 to 22.1% in 2020; P = .05) and non-Hispanic Whites (8.5% in 2014 to 14% in 2020; P = .02). In adjusted analyses, non-Hispanic Black participants (14.6%, 95% CI, 12.3%-16.7%) had a significantly higher probability of LCS discussion than non-Hispanic Whites (12.1%, 95% CI, 11.4%-12.7%). CONCLUSION Patient-provider LCS discussion was uncommon in the LCS-eligible US population. Non-Hispanic Black individuals were more likely to have LCS discussions than other racial and ethnic groups. There is a need for more research to clarify the discordance between LCS discussions and the actual screening uptake in this population.
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Affiliation(s)
- Young-Rock Hong
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL; UF Health Cancer Center, Gainesville, FL.
| | - Meghann Wheeler
- Department of Epidemiology, College of Public Health and Health Professions, University of Florida, Gainesville, FL
| | - Ruixuan Wang
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL
| | - Shama Karanth
- UF Health Cancer Center, Gainesville, FL; Department of Surgery, College of Medicine, University of Florida, Gainesville, FL
| | - Hyung-Suk Yoon
- UF Health Cancer Center, Gainesville, FL; Department of Surgery, College of Medicine, University of Florida, Gainesville, FL
| | - Rafael Meza
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada; Department of Epidemiology, University of Michigan, Ann Arbor, MI
| | - Frederick Kaye
- Division of Hematology & Oncology, College of Medicine, University of Florida, Gainesville, FL
| | - Jiang Bian
- UF Health Cancer Center, Gainesville, FL; Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL
| | - Jihyoun Jeon
- Department of Epidemiology, University of Michigan, Ann Arbor, MI
| | - Michael K Gould
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA
| | - Dejana Braithwaite
- UF Health Cancer Center, Gainesville, FL; Department of Epidemiology, College of Public Health and Health Professions, University of Florida, Gainesville, FL; Department of Surgery, College of Medicine, University of Florida, Gainesville, FL.
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Galiatsatos P, Schreiber R, Green K, Shah R, Lee H, Feller-Kopman D, Yarmus L, Thiboutot J, Lin CT, Kanarek N. Improving lung cancer screening: An equitable strategy through a tobacco treatment clinic. Prev Med Rep 2021; 24:101558. [PMID: 34976626 PMCID: PMC8683889 DOI: 10.1016/j.pmedr.2021.101558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 09/06/2021] [Accepted: 09/12/2021] [Indexed: 12/17/2022] Open
Abstract
Annual screening with low dose chest tomography has been adopted for those at high risk to aid in the early detection of lung cancer. In addition to screening, it is recommended that such persons receive evidence-based smoking-cessation. However, both lung cancer screening and evidence-based smoking-cessation strategies are underutilized in the US. We review the impact of a dedicated Tobacco Treatment Clinic (TTC), delivering evidence-based smoking cessation strategies, on lung cancer screening enrollment. Patients of the TTC, aged 50 years or older, having a minimum 20-pack-year smoking history were included. All patients had records reviewed to see if they had received lung cancer screening; if their lung cancer screening was achieved through the TTC, this was documented as “initial screening” versus “continued screening or surveillance”. Sociodemographic variables were collected as well. As for results, between January 2019 to February 2020, 92 patients enrolled in the TTC and fulfilled criteria for lung cancer screening. The mean age was 65.7 ± 8.3 years old, with 58 (63.0%) of the patients being female. Seventy-five (81.5%) patients were African American. Of the 92, 68 (73.9%) patients had lung cancer screening, with 51 patients receiving their first lung cancer screening scan through the TTC. In conclusion, through enrollment in a dedicated TTC, a significant proportion of patients were able to access lung cancer screening for the first time. Further, many of these patients were of minority status. Having a dedicated TTC may improve current health equity gaps in lung cancer screenings in certain US populations.
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Affiliation(s)
- Panagis Galiatsatos
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- The Johns Hopkins Tobacco Treatment Clinic, Johns Hopkins Bayview Medical Center, Baltimore, MD, United States
- Office of Diversity, Inclusion, and Health Equity, Johns Hopkins Medicine, Baltimore, MD, United States
- Sidney Kimmel Cancer Center, Department of Oncology, Johns Hopkins University School of Medicine
- Corresponding author at: 4940 Eastern Avenue, 4th Floor, Asthma and Allergy Building, Baltimore, MD 21224, United States.
| | - Raiza Schreiber
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kamala Green
- Baltimore City Health Department, Baltimore City, MD, United States
| | - Rohan Shah
- The Ohio State University College of Medicine, Columbus, OH, United States
| | - Hans Lee
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - David Feller-Kopman
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Lonny Yarmus
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jeffrey Thiboutot
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Cheng Ting Lin
- Department of Radiology, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Norma Kanarek
- Sidney Kimmel Cancer Center, Department of Oncology, Johns Hopkins University School of Medicine
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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