Evaluating Potential Racial Inequities in Low-dose Computed Tomography Screening for Lung Cancer

J Natl Med Assoc. 2020 Apr;112(2):209-214. doi: 10.1016/j.jnma.2019.10.002. Epub 2020 Feb 15.

Abstract

Background: Lung cancer is the leading cause of cancer death in the US, and significant racial disparities exist in lung cancer outcomes. For example, Black men experience higher lung cancer incidence and mortality rates than their White counterparts. New screening recommendations for low-dose computed tomography (LDCT) promote earlier detection of lung cancer in at-risk populations and can potentially help mitigate racial disparities in lung cancer mortality if administered equitably. Yet, little is known about the extent of racial differences in uptake of LDCT.

Objective: To evaluate potential racial disparities in LDCT screening in a large community-based cancer center in central North Carolina.

Methods: We conducted a retrospective study of the initial patients undergoing LDCT in a community-based cancer center (n = 262). We used the Pearson chi-squared test to assess potential racial disparities in LDCT screening.

Results: Study results suggest that Black patients may be less likely than White patients to receive LDCT screening when eligible (χ2 = 51.41, p < 0.0001).

Conclusion: Collaboration among healthcare providers, researchers, and decision makers is needed to promote LDCT equity.

Keywords: Disease prevention; Health disparities; Health promotion; Lung cancer screening; Minority health; Primary care.

MeSH terms

  • Black or African American / statistics & numerical data
  • Community Health Services* / methods
  • Community Health Services* / standards
  • Community Health Services* / statistics & numerical data
  • Early Detection of Cancer* / methods
  • Early Detection of Cancer* / standards
  • Early Detection of Cancer* / statistics & numerical data
  • Female
  • Health Promotion / organization & administration*
  • Healthcare Disparities / ethnology
  • Healthcare Disparities / organization & administration*
  • Humans
  • Lung Neoplasms* / diagnosis
  • Lung Neoplasms* / ethnology
  • Male
  • Middle Aged
  • North Carolina / epidemiology
  • Quality Improvement
  • Risk Assessment
  • Tomography, X-Ray Computed* / methods
  • Tomography, X-Ray Computed* / statistics & numerical data
  • White People / statistics & numerical data