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Disparities in Follow-up After Low-Dose Lung Cancer Screening.

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The National Lung Cancer Screening Trial (NLST) demonstrated an improvement in overall survival with lung cancer screening. Achieving follow-up for a positive screen is essential to impact early intervention for… Click to show full abstract

The National Lung Cancer Screening Trial (NLST) demonstrated an improvement in overall survival with lung cancer screening. Achieving follow-up for a positive screen is essential to impact early intervention for lung cancer. The objective of this study was to determine predictors of follow-up after a positive lung cancer screening test. The NLST database was queried for participants with a positive lung cancer screening exam. This cohort was then subdivided into patients who had follow-up and those that did not. Pairwise comparison was performed within different subgroups. A logistic regression model was then utilized to identify predictive factors associated with follow-up. Of the 53,454 patients who participated in the study, we identified 14,000 patients who had a positive lung cancer screening test. Of those patients, 12,503 followed up appropriately (89.3%). Women had a statistically higher follow-up rate compared to men (90% vs 88.8%, p= < 0.05). Patients reported as married or living as married also showed a higher rate of follow-up compared to patients reported as never married, divorced, separated, or widowed (90.2% vs. 87.5%, p = < 0.05). The rate of follow-up among African-American (AA) patients was 82.8%, while those in white patients was 89.6%, this was statistically significant (p= < 0.05). Education level was not a significant factor in follow-up rates. Current smokers followed up at lower rates compared to former smokers (87.9 % vs 90.6%, p = < 0.05). Logistic regression determined gender, marital status, race, and smoking status to be predictors of follow-up. Follow-up rates after a positive lung cancer screening test were associated with a patient's gender, marital status, race, and smoking status.

Keywords: status; positive lung; cancer screening; lung cancer; lung

Journal Title: Seminars in thoracic and cardiovascular surgery
Year Published: 2019

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