Open AccessAddressing Disparities in Lung Cancer Screening Eligibility and Healthcare Access. An Official American Thoracic Society Statement
Author(s) -
M. Patricia Rivera,
Hormuzd A. Katki,
Nichole T. Tanner,
Matthew Triplette,
Lori C. Sakoda,
Renda Soylemez Wiener,
Roberto Cardarelli,
Lisa CarterHarris,
Kristina Crothers,
Joelle T. Fathi,
Marvella E. Ford,
Robert A. Smith,
Robert A. Winn,
Juan P. Wisnivesky,
Louise M. Henderson,
Melinda C. Aldrich
Publication year - 2020
Publication title -
american journal of respiratory and critical care medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.272
H-Index - 374
eISSN - 1535-4970
pISSN - 1073-449X
DOI - 10.1164/rccm.202008-3053st
Subject(s) - medicine , lung cancer screening , socioeconomic status , health equity , family medicine , lung cancer , cancer screening , health care , ethnic group , environmental health , public health , cancer , population , pathology , economic growth , sociology , anthropology , economics
Background: There are well-documented disparities in lung cancer outcomes across populations. Lung cancer screening (LCS) has the potential to reduce lung cancer mortality, but for this benefit to be realized by all high-risk groups, there must be careful attention to ensuring equitable access to this lifesaving preventive health measure. Objectives: To outline current knowledge on disparities in eligibility criteria for, access to, and implementation of LCS, and to develop an official American Thoracic Society statement to propose strategies to optimize current screening guidelines and resource allocation for equitable LCS implementation and dissemination. Methods: A multidisciplinary panel with expertise in LCS, implementation science, primary care, pulmonology, health behavior, smoking cessation, epidemiology, and disparities research was convened. Participants reviewed available literature on historical disparities in cancer screening and emerging evidence of disparities in LCS. Results: Existing LCS guidelines do not consider racial, ethnic, socioeconomic, and sex-based differences in smoking behaviors or lung cancer risk. Multiple barriers, including access to screening and cost, further contribute to the inequities in implementation and dissemination of LCS. Conclusions: This statement identifies the impact of LCS eligibility criteria on vulnerable populations who are at increased risk of lung cancer but do not meet eligibility criteria for screening, as well as multiple barriers that contribute to disparities in LCS implementation. Strategies to improve the selection and dissemination of LCS in vulnerable groups are described.