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

• Published in: Cancer causes & control Vol. 34; no. Suppl 1; pp. 209 - 216
• Main Authors: Bilenduke, Emily, Anderson, Shacoria, Brenner, Alison, Currier, Jessica, Eberth, Jan M., King, Jaron, Land, Stephanie R., Risendal, Betsy C., Shannon, Jackilen, Siegel, Leeann N., Wangen, Mary, Waters, Austin R., Zahnd, Whitney E., Studts, Jamie L.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-12-2023; Springer Nature B.V
• Subjects: Biomedical and Life Sciences; Biomedicine; Cancer Research; Cancer screening; Comment; Computed tomography; Early Detection of Cancer - psychology; Epidemiology; Ethnic factors; Hematology; Humans; Information processing; Lung cancer; Lung Neoplasms - diagnosis; Lung Neoplasms - epidemiology; Lung Neoplasms - prevention & control; Medical screening; Nicotiana; Oncology; Public Health; Risk Factors; Smoking; Smoking - adverse effects; Smoking - epidemiology; Tobacco; Trends; Tobacco use; Equity; Community engagement; Intersectionality; Lung cancer screening
• ISSN: 0957-5243; 1573-7225; 1573-7225
• DOI: 10.1007/s10552-023-01790-z

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.