Disparities in statin prescription for secondary prevention of atherosclerotic cardiovascular disease in a Midwestern lung cancer screening population.

Abstract

e13723 Background: Heart issues are a leading cause of death among lung cancer patients. Statins can effectively reduce patients’ risk of cardiovascular-related death, but they are not equally prescribed across demographic subgroups. Little is understood about the use of statins among patients facing both atherosclerotic cardiovascular disease (ASCVD) and potential lung cancer. We aimed to quantify the prevalence of statin prescription for secondary ASCVD prevention among patients seeking lung cancer screening (LCS) and assess whether disparities exist. Methods: A cross-sectional, retrospective analysis was conducted of patients who underwent LCS in the Midwest from 2022-2023. Analysis was limited to patients ages 50-80 with a history of ASCVD. Variables included race/ethnicity, sex, age, cardiovascular history, and statin prescription status. Log binomial regression models were used to calculate prevalence ratios for statin prescription across race, sex, and Medicare-eligibility subgroups. Results: The prevalence of statin prescription among LCS patients with ASCVD was 70.9% (n=10,536). Black patients had a significantly higher prevalence than White patients (PR=1.09, CI=1.06-1.12); this remained true when stratifying by sex and Medicare eligibility. Female patients – specifically White, Medicare-eligible females – had a significantly lower prevalence compared to their male counterparts (PR=0.97, CI=0.95-0.99). There was no difference in prevalence between Black female and Black male patients, regardless of Medicare eligibility. Conclusions: The prevalence of secondary statin prescription among LCS patients is high but varies significantly by race and sex. Whereas race-based disparities in statin prescription appear to be closing, sex-based disparities remain salient, especially for elderly White female patients. LCS represents a valuable opportunity to identify and address gaps in ASCVD prevention. Prevalence ratios and 95% confidence intervals for statin prescription across select race and sex subgroups overall and stratified by age. Comparison Overall PR (95% CI) 50-64 PR (95% CI) 65-80 PR (95% CI) Black (ref = White) 1.09 (1.06, 1.12)* 1.13 (1.07, 1.18)* 1.08 (1.04, 1.12)* Female (ref = Male) 0.97 (0.95, 0.99)* 0.98 (0.94, 1.03) 0.97 (0.94, 0.99)* Black male (ref = White male) 1.06 (1.02, 1.11)* 1.12 (1.04, 1.20)* 1.07 (1.02, 1.11)* Black female (ref = White male) 1.08 (1.04, 1.12)* 1.10 (1.03, 1.12)* 1.04 (0.98, 1.09) White female (ref = White male) 0.95 (0.93, 0.98)* 0.97 (0.92, 1.02) 0.95 (0.92, 0.98)* Black female (ref = Black male) 1.01 (0.96, 1.06) 0.99 (0.91, 1.07) 1.03 (0.97, 1.09) *Significant. 1 Abbreviations: CI = confidence interval, PR = prevalence ratio, ref = reference.