The following is a summary of “Understanding Washington State’s Low Uptake to Lung Cancer Screening in Two Steps: A Geospatial Analysis of Patient Travel Time and Healthcare Availability of Imaging Sites,” published in the May 2024 issue of Pulmonology by Welch et al.

Early detection of lung cancer significantly reduces mortality; however, lung cancer screening (LCS) uptake remains limited in Washington State. Geographic disparities contribute to low uptake but do not fully explain the access gaps for underserved populations. Factors such as an adequate healthcare workforce to meet population demand and the capacity of accredited screening facility sites must also be considered.

Study Design and Methods This study utilized the enhanced two-step floating catchment area (E2SFCA) model to assess how geographic accessibility and the availability of LCS imaging centers contribute to disparities in screening uptake. Data on radiologic technologist volume at each American College of Radiology (ACR) accredited screening facility were used to estimate each site’s capacity to meet potential population demand. Spearman rank correlation coefficients of the spatial access ratios (SPARs) were compared with the 2010 Rural-Urban Commuting Area (RUCA) codes and Area Deprivation Index (ADI) quintiles to identify characteristics of populations at risk for lung cancer with varying levels of access.

Results The study identified 549 radiologic technologists across 95 ACR-accredited screening facilities. It was found that 95% of the eligible population had proximate geographic access to an ACR facility. However, incorporating the E2SFCA method revealed significant variation in access for eligible populations. The inclusion of the availability measure showed that access was attenuated for most of the eligible population. 

Furthermore, there was a substantial correlation between rural areas and lower access, while areas with greater socioeconomic disadvantage also showed modestly lower access.

Conclusions This study underscores the complexity of addressing low LCS uptake, highlighting the importance of both geographic accessibility and the availability of adequate healthcare resources. The findings suggest that targeted interventions are necessary to improve access in rural and socioeconomically disadvantaged areas, thereby enhancing early detection and reducing lung cancer mortality.

Source: sciencedirect.com/science/article/abs/pii/S0012369224006573