Urban–Rural Disparities in Access to Low-Dose Computed Tomography Lung Cancer Screening in Missouri and Illinois

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Rohatgi, Karthik W. ; Marx, Christine M. ; Lewis-Thames, Marquita W. ; Liu, Jingxia ; Colditz, Graham A. ; James, Aimee S.
• Description:
  Introduction
  
  Low-dose computed tomography (LDCT) lung cancer screening is recommended for current and former smokers who meet eligibility criteria. Few studies have quantitatively examined disparities in access to LDCT screening. The objective of this study was to examine relationships between 1) rurality, sociodemographic characteristics, and access to LDCT lung cancer screening and 2) screening access and lung cancer mortality.
  
  Methods
  
  We used census block group and county-level data from Missouri and Illinois. We defined access to screening as presence of an accredited screening center within 30 miles of residence as of May 2019. We used mixed-effects logistic models for screening access and county-level multiple linear regression models for lung cancer mortality.
  
  Results
  
  Approximately 97.6% of metropolitan residents had access to screening, compared with 41.0% of nonmetropolitan residents. After controlling for sociodemographic characteristics, the odds of having access to screening in rural areas were 17% of the odds in metropolitan areas (95% CI, 12%–26%). We observed no association between screening access and lung cancer mortality. Southeastern Missouri, a rural and impoverished area, had low levels of screening access, high smoking prevalence, and high lung cancer mortality.
  
  Conclusion
  
  Although access to LDCT is lower in rural areas than in urban areas, lung cancer mortality in rural residents is multifactorial and cannot be explained by access alone. Targeted efforts to implement rural LDCT screening could reduce geographic disparities in access, although further research is needed to understand how increased access to screening could affect uptake and rural disparities in lung cancer mortality.
  
  
• Subjects:
  Original Research
• Source:
  Prev Chronic Dis. 2020; 17
• ISSN:
  1545-1151
• Pubmed ID:
  33155970
• Pubmed Central ID:
  PMC7665516
• Document Type:
  Journal Article
• Place as Subject:
  Illinois ; Missouri
• Location:
  North America
• Volume:
  17
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:a1592546f107211773e3c09be1a622d09f48e46122cef9da3bbcc7337eb2cf753314b563c6e9129359e427d938692afe1e31f55cda73e464e9a9fa2414edb97f
• Download URL:
  https://stacks.cdc.gov/view/cdc/97442/cdc_97442_DS1.pdf
• File Type:
  [PDF - 797.61 KB ]