Lung cancer screening uptake among high-risk populations in michigan

SESSION TITLE: Lung Cancer Posters 2 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: Lung cancer is the leading cause of mortality in men and women in the U.S. Lung cancer screening with low-dose chest Computed Tomography (CT) has been shown to reduce lung cancer mortality by 20-24% for high-risk patients (based on age and smoking status) in the National Lung Screening Trial (NLST) and the Dutch-Belgian Randomized Lung Cancer Screening Trial (NELSON). Despite this evidence supporting lung cancer screening, we continue to face challenges with low proportion of eligible patients being screened. According to data published in 2018, nationally, only 5% of eligible current and former smokers nationally and 8% of eligible patients in Michigan are being screened. Our aim in this study was to determine current uptake of lung cancer screening in a health system based centralized lung cancer screening (LCS) program. METHODS: Henry Ford Health System in Metropolitan-Detroit launched a centralized LCS program through its Interventional Pulmonary team in 2018. In this analysis, we included all patients aged 50-77 years who had a visit between July 1, 2020 and June 30, 2022. Using a previously published algorithm (Kukhareva et al 2022), lung screening eligibility was assessed, using both the most recent EHR smoking history as well as longitudinal EHR smoking history over time. Patients with prior lung cancer diagnosis were excluded. Percent of eligible patients who received a screening CT or CT for other purposes within the 12 months prior to eligibility assessment was determined overall and compared across race-sex groups by chi-square test. Simple logistic regression was used to compare race-sex groups with white males as the referent group. RESULTS: Of the total 495,258 patients captured to assess screening uptake, 44,089 patients (23%) were eligible for screening based on age and smoking history. Of these 52% were female and 22% were Black. 17% of eligible patients (7,396) received a screening CT within the previous 12 months. The highest proportion screened among eligible patients was observed for Black females at 21%, while the lowest proportion was for White males (16%). When compared to White males, Black females (21%, p<0.001) and Black males (18%, p<0.001) had a significantly higher proportion of eligible patients completing screening. We observed no difference in screening uptake between White females and males (p=0.5). When considering screening and non-screening CTs, the proportion of eligible patients up-to-date with screening increased to 30% (N=13,004). CONCLUSIONS: Implementation of a centralized LCS program has streamlined the LCS process leading to higher proportions of eligible patients undergoing screening than previously reported. Further, our program appears to be effective for our Black patients. CLINICAL IMPLICATIONS: Although our centralized program has higher screening proportions than some previous reports, a significant gap still exists in LCS uptake among eligible patients, leading to missed opportunities for early detection and timely intervention. This highlights the importance of improving healthcare providers' awareness and adherence to screening guidelines and enhancing access to screening programs for high-risk populations. Additionally, targeted outreach and education efforts may help address disparities in screening rates among different demographic groups, contributing to better patient outcomes and reducing lung cancer mortality. DISCLOSURES: No relevant relationships by Elizabeth Alleman No relevant relationships by Jessica Dagenais No relevant relationships by Vritti Gupta No relevant relationships by Cindy Lambdin No relevant relationships by Katie Latack Grantee relationship with Genentech Please note: Jan 2021-Dec 2023 Added 03/31/2023 by Christine Neslund-Dudas, source=Web Response, value=Grant/Research Support Consultant relationship with CleanScreen Consulting L.L.C. Please note: 2021 by Lana Saugrich, value=Salary No relevant relationships by Michael Sheehan Scientific Medical Advisor relationship with Gongwin Biopharm Please note: $5001 - $20000 by Michael Simoff, value=Consulting fee Employee relationship with Intuitive Please note: Feb 2022 to current by Michael Simoff, value=Salary No relevant relationships by Katie Zarins