Bridging gaps: Evaluating the impact of urban lung cancer screening on diverse populations.

Abstract

e13835 Background: Lung cancer (LC) screening reduces mortality in high-risk populations, yet disparities persist, particularly among Hispanic individuals who are often diagnosed at advanced stages and less likely to meet screening criteria. In 2024, Florida’s LC screening rate for high-risk individuals reached 15.8%, aligning with the national average of 16% and marking an improvement from previous years. This study evaluates the effectiveness of an LC screening program in a predominantly urban setting, focusing on follow-up outcomes among underserved populations disproportionately impacted by LC. Methods: A retrospective analysis was conducted on LC screening data from the University of Miami’s screening program between January 2022 and April 2024. Demographic variables, Lung-RADS classifications, and follow-up rates (defined as completed within 1 year and 90 days after an initial scan) were analyzed to assess program performance. Associations between screening adherence and demographic characteristics were examined using multivariate analysis. Results: The cohort included 661 patients, predominantly male (55%), with 85.9% identifying as White, 8.8% as Black, and 5% as Other. Nearly half (50.9%) were Hispanic, while 44% were non-Hispanic. Most patients (88.4%) had Lung-RADS categories 1–2, while 7.1% had category 3, and 4.5% had category 4. Multivariate analysis revealed that older age significantly increased the likelihood of follow-up visits (OR = 1.04 per year, p = 0.014). Although non-Hispanic patients had slightly higher odds of follow-up, the difference was not statistically significant (OR = 1.26, p = 0.199). However, White patients were significantly more likely than Black patients to repeat imaging for both Lung-RADS 3 (OR = 1.57; 95% CI: 1.10–2.23; p = 0.012) and Lung-RADS 4 (OR = 1.72; 95% CI: 1.23–2.42; p = 0.003). Conclusions: LC screening programs in urban, predominantly Hispanic populations face unique challenges, including lower adherence and socioeconomic barriers. Tailored, culturally competent interventions are essential for improving follow-up rates and ensuring equitable access to early detection and treatment. Expanding these efforts can contribute to broader public health goals of reducing disparities in LC screening and outcomes.