Examination of the Association Between Access to Care and Lung Cancer Screening Among High-Risk Smokers

Bibliographic Data

ID22090856
AuthorsChien‐Ching Li (0000-0002-3817-0510, Rush University, corresponding author), Chien-Ching Li, Alicia K Matthews (0000-0002-0074-681X, University of Illinois Chicago), Yu-Hsiang Kao (0000-0003-3560-5889, Louisiana State University Health Sciences Center New Orleans), Wei-Ting Lin (0000-0002-7602-5592), Wei‐Ting Lin (0000-0001-5556-2754, Tulane University), Jad Bahhur (Rush University Medical Center), L Dowling (0009-0000-0904-5545, Rush University Medical Center)
Year2021
Volume9
Pages684558-684558
Publication date2021-08-25
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2021.684558
PMID34513780
OpenAlexW3195004694
LanguageEN
References cited65

Objective: The purpose of this study was to examine the influence of access to care on the uptake of low-dose computed tomography (LDCT) lung cancer screening among a diverse sample of screening-eligible patients. Methods: We utilized a cross-sectional study design. Our sample included patients evaluated for lung cancer screening at a large academic medical center (AMC) between 2015 and 2017 who met 2013 USPSTF guidelines for LDCT screening eligibility. The completion of LDCT screening (yes, no) was the primary dependent variable. The independent variable was access to care (insurance type, living within the AMC service area). We utilized binary logistic regression analyses to examine the influence of access to care on screening completion after adjusting for demographic factors (age, sex, race) and smoking history (current smoking status, smoking pack-year history). Results: A total of 1,355 individuals met LDCT eligibility criteria, and of those, 29.8% ( n = 404) completed screening. Regression analysis results showed individuals with Medicaid insurance (OR, 1.51; 95% CI, 1.03-2.22), individuals living within the AMC service area (OR, 1.71; 95% CI, 1.21–2.40), and those aged 65–74 years (OR, 1.49; 95% CI, 1.12–1.98) had higher odds of receiving LDCT lung cancer screening. Lower odds of screening were associated with having Medicare insurance (OR, 0.30; 95% CI, 0.22–0.41) and out-of-pocket (OR, 0.27; 95% CI, 0.15–0.47). Conclusion: Access to care was independently associated with lowered screening rates. Study results are consistent with prior research identifying the importance of access factors on uptake of cancer early detection screening behaviors

Cancer · Cancer screening · Cross-sectional study · Family medicine · Health care · Logistic regression · Lung cancer · Lung cancer screening · Medicaid · Odds ratio · Pathology · Colorectal Cancer Screening and Detection · Global Cancer Incidence and Screening · Lung Cancer Diagnosis and Treatment · Medicine · Internal Medicine