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

Early detection of lung cancer is crucial for reducing mortality; however, the uptake of lung cancer screening (LCS) in Washington State remains suboptimal. While geographic disparities contribute to limited uptake, they do not fully account for the gaps in access experienced by underserved populations. Other critical factors, including the adequacy of the workforce and the capacity of accredited screening facilities, play a significant role. To evaluate the extent of access to LCS facilities, researchers utilized the enhanced two-step floating catchment area (E2SFCA) model to analyze both geographic accessibility and the availability of imaging centers. 

Investigators incorporated data on radiologic technologist volumes at each American College of Radiology (ACR)-accredited facility to estimate the capacity to meet potential population demand. Spearman rank correlation coefficients were used to compare spatial access ratios with the 2010 Rural-Urban Commuting Area codes and area deprivation index quintiles, aiming to identify characteristics of populations at risk for lung cancer and their access levels. The analysis identified 549 radiologic technologists across 95 ACR-accredited screening facilities. While 95% of the eligible population had proximal geographic access to at least one ACR facility, significant variations in access emerged when considering facility capacity using the E2SFCA model. 

This approach revealed that the effective access to screening facilities was considerably lower for most of the eligible population once facility availability was factored in. Rural areas showed substantial correlations with lower access levels, while socioeconomic disadvantage correlated modestly with reduced access. These findings underscore the need to address both geographic and capacity-related barriers to improve access to lung cancer screening, particularly in underserved and disadvantaged populations.

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