Uptake of Lung Cancer Screening CT After a Provider Order for Screening in the PROSPR-Lung Consortium
Recommended Citation
Neslund-Dudas C, Tang A, Alleman E, Zarins KR, Li P, Simoff MJ, Lafata JE, Rendle KA, Hartman ANB, Honda SA, Oshiro C, Olaiya O, Greenlee RT, Vachani A, and Ritzwoller DP. Uptake of Lung Cancer Screening CT After a Provider Order for Screening in the PROSPR-Lung Consortium. J Gen Intern Med 2023.
Document Type
Article
Publication Date
2-1-2024
Publication Title
Journal of general internal medicine
Abstract
BACKGROUND: Uptake of lung cancer screening (LCS) has been slow with less than 20% of eligible people who currently or formerly smoked reported to have undergone a screening CT.
OBJECTIVE: To determine individual-, health system-, and neighborhood-level factors associated with LCS uptake after a provider order for screening.
DESIGN AND SUBJECTS: We conducted an observational cohort study of screening-eligible patients within the Population-based Research to Optimize the Screening Process (PROSPR)-Lung Consortium who received a radiology referral/order for a baseline low-dose screening CT (LDCT) from a healthcare provider between January 1, 2015, and June 30, 2019.
MAIN MEASURES: The primary outcome is screening uptake, defined as LCS-LDCT completion within 90 days of the screening order date.
KEY RESULTS: During the study period, 18,294 patients received their first order for LCS-LDCT. Orders more than doubled from the beginning to the end of the study period. Overall, 60% of patients completed screening after receiving their first LCS-LDCT order. Across health systems, uptake varied from 41 to 87%. In both univariate and multivariable analyses, older age, male sex, former smoking status, COPD, and receiving care in a centralized LCS program were positively associated with completing LCS-LDCT. Unknown insurance status, other or unknown race, and lower neighborhood socioeconomic status, as measured by the Yost Index, were negatively associated with screening uptake.
CONCLUSIONS: Overall, 40% of patients referred for LCS did not complete a LDCT within 90 days, highlighting a substantial gap in the lung screening care pathway, particularly in decentralized screening programs.
Medical Subject Headings
Humans; Male; Lung Neoplasms; Cohort Studies; Early Detection of Cancer; Tomography, X-Ray Computed; Lung; Mass Screening
PubMed ID
37783984
ePublication
ePub ahead of print
Volume
39
Issue
2
First Page
186
Last Page
194
