Equitable implementation of lung cancer screening: avoiding its potential to mirror existing inequities among people who use tobacco

• Type of Material: Article
• Authors: Emily Bilenduke, University of Colorado, Denver; Shacoria Anderson, Emory University; Alison Brenner, University of North Carolina, Chapel Hill; Jessica Currier, Oregon Health and Science University; Jan M. Eberth, Drexel University; Jaron King, University of South Carolina, Columbia; Stephanie R. Land, national cancer Institute; Betsy C. Risendal, University of Colorado, Aurora; Jackilen Shannon, Oregon Health and Science University; Leeann N. Siegel, National cancer Institute; Mary Wangen, University of North Carolina, Chapel Hill; Austin R. Waters, University of North Carolina, Chapel Hill; Whiteny E. Zahnd, University of Iowa; jamie L. Studts, University of Colorado, Aurora
• Language: English
• Date: 2023-09-15
• Publisher: Springer
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2023
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): https://doi.org/10.1007/s10552-023-01790-z
• Title of Journal or Parent Work: Cancer Causes and Control
• Volume: 34
• Start Page: 209
• End Page: 216
• Grant/Funding Information: This paper was published as part of a supplement sponsored by the Cancer Prevention and Control Research Network (CPCRN), a thematic network of the Prevention Research Center Program and supported by the Centers for Disease Control and Prevention (CDC). Work on this paper was funded [in part/in full] by the Division of Cancer Prevention and Control, the National Center for Chronic Disease Prevention, and Health Promotion of the Centers for Disease Control and Prevention, U.S. Department of Health and Human Services (HHS) under Cooperative Agreement Numbers [U48 DP006399, U48 DP006400, U48 DP006401, and U48 DP006389]. The findings and conclusions in this article are those of the authors and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government. Austin R. Waters is supported by the National Cancer Institute’s National Research Service Award sponsored by the Lineberger Comprehensive Cancer Center at the University of North Carolina (T32 CA116339). Jamie Studts effort was partially supported by grants from the Bristol Myers Squibb Foundation (501(c)3) and the National Cancer Institute (R01CA254734). This publication was made possible by grant number R21CA234295 (Eberth) from the National Cancer Institute at the National Institutes of Health. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NCI. This publication was made possible for Jessica Currier and Jackilen Shannon by grant number P30CA069533 (Druker) from the National Cancer Institute at the National Institutes of Health.
• Keywords: Intersectionality; Community engagement; Tobacco use; Equity; Lung cancer screening
• Research Categories: Health Sciences, Public Health; Health Sciences, Oncology

Abstract

Purpose Lung cancer is the leading cause of cancer death, but the advent of lung cancer screening using low-dose computed tomography offers a tremendous opportunity to improve lung cancer outcomes. Unfortunately, implementation of lung cancer screening has been hampered by substantial barriers and remains suboptimal. Specifically, the commentary emphasizes the intersectionality of smoking history and several important sociodemographic characteristics and identities that should inform lung cancer screening outreach and engagement efforts, including socioeconomic considerations (e.g., health insurance status), racial and ethnic identity, LGBTQ + identity, mental health history, military experience/veteran status, and geographic residence in addressing specific community risk factors and future interventions in efforts to make strides toward equitable lung cancer screening. Methods Members of the Equitable Implementation of Lung Cancer Screening Interest Group with the Cancer Prevention and Control Network (CPCRN) provide a critical commentary based on existing literature regarding smoking trends in the US and lung cancer screening uptake to propose opportunities to enhance implementation and support equitable distribution of the benefits of lung cancer screening. Conclusion The present commentary utilizes information about historical trends in tobacco use to highlight opportunities for targeted outreach efforts to engage communities at high risk with information about the lung cancer screening opportunity. Future efforts toward equitable implementation of lung cancer screening should focus on multi-level implementation strategies that engage and work in concert with community partners to co-create approaches that leverage strengths and reduce barriers within specific communities to achieve the potential of lung cancer screening.