Abstract
Abstract Background: The National Lung Screening Trial (NLST) demonstrated that lung cancer screening reduces lung cancer mortality by 20% in high risk individuals. The rate of adherence to screening was more than 90% in the NSLT in a predominant non- Hispanic White (NHW) population, with only 1.8% Hispanics. Concerns regarding adherence in lung cancer screening have been widely reported. The goal of our study was to investigate the attributes of a Lung Cancer (LC) screening program and factors associated with screening adherence in a largely Hispanic urban population and compare with the NLST population. Methods: We performed a retrospective analysis of 421 consecutive cases who underwent LDCT screening from 2016-2019 at the University of Miami (UM), with similar inclusion criteria as the NLST. Annual adherence was defined as returning for imaging within 1 year and 90 days after an initial negative scan. Screening results, LC detection and screening adherence were examined and compared with the NLST cohort using summary statistics and X2 test for categorical variables. Association between adherence and baseline factors including age, gender, race/ethnicity, insurance, smoking history, and COPD was analyzed. Results: A total of 421 patients underwent screening from 2016-2019. UM cohort had a different racial and ethnic profile, with a higher percentage of Hispanics (47.3% vs 1.8%) and African Americans (15% vs 4.5%) in the UM than the NLST cohort respectively. Compared with NLST Low-Dose Computed Tomography (LDCT) arm, the UM cohort had fewer active smokers and a lighter smoking history. The proportion of positive LDCT screens (Lung-RADS Class 3/4) in the UM cohort (14.1%) was comparable to the NLST cohort (13.7%). Eighty-five percent of initial scans (359 of 421) were benign (Lung-RADS Class 1/2). The no-show rate for the LDCT screening shared-decision visit was 26% (228 of 891 visits). Early adherence rate to repeat annual imaging was 31.4% (81/258) Factors associated with early adherence included gender smoking, and race/ethnicity, with greater adherence in men than women, former smokers, and patients of NHW ethnicity. Despite, lower adherence to screening, the UM cohort had higher LC detection rate (3.3%) than the NLST cohort (1.1%) (p<0.001). Conclusion: Nonadherence to LDCT screening recommendations and non-compliance to shared decision making visits is common in a urban-based LDCT screening program. More data is needed to understand obstacles to compliance with screening in minority populations nationwide. Citation Format: Estelamari Rodriguez, Marie Jeanette Charles, Sophie Torrents, Richa Dawar, Nestor Villamizar, Dao Minh Nguyen, Kunal Gawri. Factors determining adherence to lung cancer screening in a Hispanic urban population [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-256.