Lung cancer screening utilization rate varies based on patient, provider, and hospital factors
Title
Lung cancer screening utilization rate varies based on patient, provider, and hospital factors
Creator
Tarik Whitham
Koffi Wima
Brett Harnett
John R Kues
Mark H Eckman
Sandra L Starnes
Katherine A Schmidt
Sangita Kapur
Hai Salfity
Robert M Van Haren
Date
2023
Description
Objective: Low-dose computed tomography has been proven to reduce mortality, yet utilization remains low. The purpose of this study is to identify factors that impact the utilization of lung cancer screening.
Methods: We performed a retrospective review of our institution's primary care network from November 2012 to June 2022 to identify patients who were eligible for lung cancer screening. Eligible patients were 55 to 80 years of age and current or former smokers with at least a 30 pack-year history. Analyses were performed on the screened populations and patients who met eligibility criteria but were not screened.
Results: A total of 35,279 patients in our primary care network were current/former smokers aged 55 to 80 years. A total of 6731 patients (19%) had a 30 pack-year or more cigarette history, and 11,602 patients (33%) had an unknown pack-year history. A total of 1218 patients received low-dose computed tomography. The utilization rate of low-dose computed tomography was 18%. The utilization rate was significantly lower (9%) if patients with unknown pack-year history were included (P < .001). The utilization rates between primary care clinic locations were significantly different (range, 18% vs 41%, P < .05). Utilization of low-dose computed tomography on multivariate analysis was associated with Black race, former smoker, chronic obstructive pulmonary disease, bronchitis, family history of lung cancer, and number of primary care visits (all P < .05).
Conclusions: Lung cancer screening utilization rates are low and vary significantly on the basis of patient comorbidities, family history of lung cancer, primary care clinic location, and accurate documentation of pack-year cigarette history. The development of programs to address patient, provider, and hospital-level factors is needed to ensure appropriate lung cancer screening.
Methods: We performed a retrospective review of our institution's primary care network from November 2012 to June 2022 to identify patients who were eligible for lung cancer screening. Eligible patients were 55 to 80 years of age and current or former smokers with at least a 30 pack-year history. Analyses were performed on the screened populations and patients who met eligibility criteria but were not screened.
Results: A total of 35,279 patients in our primary care network were current/former smokers aged 55 to 80 years. A total of 6731 patients (19%) had a 30 pack-year or more cigarette history, and 11,602 patients (33%) had an unknown pack-year history. A total of 1218 patients received low-dose computed tomography. The utilization rate of low-dose computed tomography was 18%. The utilization rate was significantly lower (9%) if patients with unknown pack-year history were included (P < .001). The utilization rates between primary care clinic locations were significantly different (range, 18% vs 41%, P < .05). Utilization of low-dose computed tomography on multivariate analysis was associated with Black race, former smoker, chronic obstructive pulmonary disease, bronchitis, family history of lung cancer, and number of primary care visits (all P < .05).
Conclusions: Lung cancer screening utilization rates are low and vary significantly on the basis of patient comorbidities, family history of lung cancer, primary care clinic location, and accurate documentation of pack-year cigarette history. The development of programs to address patient, provider, and hospital-level factors is needed to ensure appropriate lung cancer screening.
Source
J Thorac Cardiovasc Surg
. 2023 Feb 21;S0022-5223(23)00172-1. doi: 10.1016/j.jtcvs.2023.01.032. Online ahead of print.
. 2023 Feb 21;S0022-5223(23)00172-1. doi: 10.1016/j.jtcvs.2023.01.032. Online ahead of print.
Language
English
URL
10.1016/j.jtcvs.2023.01.032
Citation
Tarik Whitham et al., “Lung cancer screening utilization rate varies based on patient, provider, and hospital factors,” NEOMED Bibliography Database, accessed April 27, 2024, https://neomed.omeka.net/items/show/12279.