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Lung Cancer Screening Penetration in an Urban Underserved County

  • LUNG CANCER SCREENING
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Abstract

Purpose

To compare residential geography, sex, socioeconomic status (SES), and race/ethnicity of patients screened at Montefiore’s Lung Cancer Screening Program with those of patients diagnosed with lung cancer, assessing whether screening efforts are appropriately focused.

Methods

This retrospective cohort study involved patients within a multisite urban medical center undergoing lung cancer screening or diagnosed with lung cancer from January 1, 2015 to December 31, 2019. Inclusion criteria were residence within the Bronx, NY and age between 55 and 80 years. Institutional review board approval was obtained. Data were analyzed using the Wilcoxon two-sample t test and χ2.

Results

The cohorts comprised 1568 (50.3%) women and 1551 (49.7%) men (mean age 65.6 ± 6.16). The Southeast Bronx had the most diagnosed lung cancers (29.96%) and screenings (31.22%). Sex did not significantly differ (p = 0.053). Cancer and screening cohorts were from impoverished neighborhoods with mean SES of − 3.11 ± 2.78 and − 3.44 ± 2.80 (p < 0.01). The lower tier SES neighborhoods demonstrated more patients in the screening cohort than cancer cohort (p = 0.01). Both cohorts included a majority of Hispanic patients, although race/ethnicity differed significantly (p = 0.01). Lower SES neighborhoods showed no significant difference in race/ethnicity between cancer and screening cohorts (p = 0.262).

Conclusion

Though statistically significant differences were found between cohorts, likely due to sample size, few clinically meaningful differences were found, implying our lung cancer screening program was effective in reaching the desired population. Demographics-based programs should be considered in global efforts to screen vulnerable populations.

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References

  1. Welcker K (2015) Gender differences in lung cancer. Zentralbl Chir 140(3):260–265

    CAS  PubMed  Google Scholar 

  2. Aldrich MC et al (2013) Socioeconomic status and lung cancer: unraveling the contribution of genetic admixture. Am J Public Health 103(10):e73-80

    Article  PubMed  PubMed Central  Google Scholar 

  3. Stram DO et al (2019) Racial/Ethnic differences in lung cancer incidence in the multiethnic cohort study: an update. J Natl Cancer Inst 111(8):811–819

    Article  PubMed  PubMed Central  Google Scholar 

  4. Adie Y et al (2020) Neighborhood disadvantage and lung cancer incidence in ever-smokers at a safety net health-care system: a retrospective study. Chest 157(4):1021–1029

    Article  PubMed  Google Scholar 

  5. Hovanec J et al (2018) Lung cancer and socioeconomic status in a pooled analysis of case-control studies. PLoS ONE 13(2):e0192999

    Article  PubMed  PubMed Central  Google Scholar 

  6. Roux AVD et al (2001) Neighborhood of residence and incidence of coronary heart disease. N Engl J Med 345(2):99–106

    Article  Google Scholar 

  7. Rahman S et al (2009) Access to mammography facilities and detection of breast cancer by screening mammography: a GIS approach. Int J Canc Prev 2(6):403–413

    PubMed  PubMed Central  Google Scholar 

  8. Kale MS et al (2019) The landscape of US lung cancer screening services. Chest 155(5):900–907

    Article  PubMed  Google Scholar 

  9. Williams LB et al (2019) Design of a community-based lung cancer education, prevention, and screening program. West J Nurs Res 41(8):1152–1169

    Article  PubMed  Google Scholar 

  10. Shulman E et al (2019) Relative contribution of modifiable risk factors for incident atrial fibrillation in Hispanics, African Americans and non-Hispanic Whites. Int J Cardiol 275:89–94

    Article  PubMed  Google Scholar 

  11. Bortnick AE et al (2020) Outcomes of ST-elevation myocardial infarction by age and sex in a low-income urban community: the Montefiore STEMI Registry. Clin Cardiol 43(10).

  12. Kargoli F et al (2017) Socioeconomic status as a predictor of mortality in patients admitted with atrial fibrillation. Am J Cardiol 119(9):1378–1381

    Article  PubMed  Google Scholar 

  13. Durand M-A et al (2018) What matters most: protocol for a randomized controlled trial of breast cancer surgery encounter decision aids across socioeconomic strata. BMC Public Health 18(1):241

    Article  PubMed  PubMed Central  Google Scholar 

  14. (USDA), U.S.D.o.A., Percent of total population in poverty, 2020: New York. 2022: Economic Research Service.

  15. Liao DZ et al (2019) Association of delayed time to treatment initiation with overall survival and recurrence among patients with head and neck squamous cell carcinoma in an underserved urban population. JAMA Otolaryngol Head Neck Surg 145(11):1001

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kaminetzky M et al (2019) Effectiveness of lung-RADS in reducing false-positive results in a diverse, underserved, urban lung cancer screening cohort. J Am Coll Radiol 16(4 Pt A):419–426

    Article  PubMed  Google Scholar 

  17. New York State Department of Health, Lung Cancer Incidence and Mortality by Year, Bronx County, 1976–2016. 2019.

  18. New York State Department of Health, ZIP Code Definitions of New York City Neighborhoods. 2006.

  19. American College of Radiology, ACR Appropriateness Criteria. 2018.

  20. (USPSTF), U.S.P.S.T.F., Lung Cancer: Screening. 2013, Agency for Healthcare Research and Quality: Rockville, MD: U.S. Dept. of Health & Human Services.

  21. Schütte S et al (2018) Participation in lung cancer screening programs: are there gender and social differences? A systematic review. Public Health Rev 39:23

    Article  PubMed  PubMed Central  Google Scholar 

  22. Durand MA et al (2021) What matters most: randomized controlled trial of breast cancer surgery conversation aids across socioeconomic strata. Cancer 127(3):422–436

    Article  PubMed  Google Scholar 

  23. Raez LE et al (2020) Lung cancer disparities in Hispanics: molecular diagnosis and use of immunotherapy. JCO Global Oncol 6:784–788

    Article  Google Scholar 

  24. Soto GJ, Martin GS, Gong MN (2013) Healthcare disparities in critical illness. Crit Care Med 41(12):2784–2793

    Article  PubMed  Google Scholar 

  25. Khambaty T et al (2020) Elucidating the multidimensionality of socioeconomic status in relation to metabolic syndrome in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Int J Behav Med 27(2):188–199

    Article  PubMed  PubMed Central  Google Scholar 

  26. Melzer AC, Wilt TJ (2021) Expanded access to lung cancer screening—implementing wisely to optimize health. JAMA Netw Open 4(3):e210275–e210275

    Article  PubMed  Google Scholar 

  27. Raghavan D et al (2019) Initial results from mobile low-dose computerized tomographic lung cancer screening unit: improved outcomes for underserved populations. Oncologist 25:e777–e781

    Article  PubMed  PubMed Central  Google Scholar 

  28. Dawe DE et al (2017) Geographical variation and factors associated with non-small cell lung cancer in Manitoba. Can Respir J 2017:7915905

    Article  PubMed  PubMed Central  Google Scholar 

  29. (US), O.o.S.a.H., Cancer among adults from exposure to secondhand smoke. In: The health consequences of involuntary exposure to tobacco smoke: a report of the surgeon general. 2006, Centers for Disease Control and Prevention (US).

  30. Chen A et al (2019) Socioeconomic differences in nicotine exposure and dependence in adult daily smokers. BMC Public Health 19(1):375

    Article  PubMed  PubMed Central  Google Scholar 

  31. Smeltzer M et al (2021) Comparing U.S. Preventive Services Task Force 2013 versus 2021 lung cancer screening eligibility. J Clin Oncol 39(28_suppl): 13–13.

  32. Tabaac AR et al (2018) Gender identity disparities in cancer screening behaviors. Am J Prev Med 54(3):385–393

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors have no grants or funding to disclose.

Funding

The authors declare that no funds, grants, or other support were received from any organization during the preparation of this manuscript. The authors have no relevant financial or non-financial interests to disclose.

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Authors and Affiliations

  1. Montefiore Medical Center, Radiology, 111 East 210Th Street, Bronx, NY, 10567, USA

    Kristen Lee, Edward Mardakhaev & Arash Gohari

  2. Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, New Haven, CT, 06510, USA

    Linda Broyde Haramati

  3. Department of Epidemiology & Population Health, Montefiore Medical Center, 1300 Morris Park Avenue, Bronx, NY, 10461, USA

    Kenny Ye & Juan Lin

Authors
  1. Kristen Lee
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  2. Linda Broyde Haramati
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  3. Kenny Ye
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  4. Juan Lin
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  5. Edward Mardakhaev
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  6. Arash Gohari
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by KL, MD, EM, MD, and AG, MD. Data analysis was performed by KY, PhD and JL, PhD. The first draft of the manuscript was written by the corresponding author, KL, MD, and all authors commented on versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kristen Lee.

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Conflict of interest

The authors have no competing interests to declare that are relevant to the content of this article. The authors have no financial or proprietary interests in any material discussed in this article.

Ethical Approval

Institutional Review Board (IRB) (#2014-3310) and Health Insurance Portability and Accountability (HIPAA) approval for this study were obtained through the Einstein Human Research Protection Program. Ethical approval was waived by the IRB under the Einstein Human Research Protection Program after extensive consultation, as the study was retrospective in nature and all procedures performed were in line with routine patient care.

Consent to Participate

Informed consent was waived by the IRB through the Einstein Human Research Protection Program.

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Lee, K., Haramati, L.B., Ye, K. et al. Lung Cancer Screening Penetration in an Urban Underserved County. Lung 201, 243–249 (2023). https://doi.org/10.1007/s00408-023-00609-7

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  • DOI: https://doi.org/10.1007/s00408-023-00609-7

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