An examination of geographic access among the eligible population to lung cancer screening across US counties

Authors: Liora Sahar*, American Cancer Society, Vanhvilai Lisa Douangchai Wills, American Cancer Society, Ka Kit Liu, American Cancer Society, Stacey Fedewa, American Cancer Society, Robert Smith, American Cancer Society
Topics: Geographic Information Science and Systems
Keywords: GIS, Access to Screening, Lung Cancer, Rural
Session Type: Virtual Paper
Presentation File: No File Uploaded


Lung cancer is a leading cause of cancer deaths in the US and it has a low 5-year survival rate mainly due to the high proportion of late stage diagnosis. Several organizations, including the US Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS) recommend screening for adults at high-risk as a measure to reduce mortality, but screening rates remain low. Recently, the USPSTF released a draft update of their recommendation, which presently targets adults ages 55-80 who currently smoke or have quit smoking within the past 15 years and have a 30 pack-year smoking history. The proposed modification would lower the age to 50 and reduce the pack-year history to 20. These changes are expected to substantially increase the number of the eligible at-risk population.

This study extends upon a report that focused on geographic access to screening of the entire 55-79 population and provides an assessment of access to screening among those eligible aged 50-79 years, as defined by the USPSTF’s proposed draft recommendations. This project aligns with various ACS initiatives that focus on cancer prevention and its role as a founding organization of the National Lung Cancer Roundtable (NLCRT).

This study examines access to facilities accredited by the American College of Radiology. We utilize network analysis to calculate travel distances from population centers (census tracts) to facilities. Results are presented across rural and urban settings and at different geographic levels to inform decision making and describe observed differences and potential disparities in access to screening.

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