Lung Cancer Screening by Nativity Among Latino Community Health Center Patients.

Abstract

Introduction: United States Preventive Service Task Force guidelines recommend annual low-dose computed tomography for lung cancer screening (LCS) for people with significant history of cigarette use. While the national prevalence of lung cancer screening remains low, with known racial and ethnic disparities, studies have yet to examine LCS screening disparities by nativity among Latino patients.

Methods: We evaluated the documentation and prevalence of LCS orders in the electronic health record in Latino patients, by place of birth, in a multistate network of community health centers, over a 10-year study period (2013 to 2022), adjusting for patient and clinical demographic factors.

Results: Among patients who reported current or former cigarette use (n = 126,528), the prevalence of a LCS order was 7.3%. Among 62,483 patients with a documented 30+ year pack-history, US-born Latinos had equal odds as non-Latino Whites to have LCS ordered (OR = 0.71, 95% CI = 0.42-1.21), while odds were lower for both foreign-born Latinos (OR = 0.47, 95% CI = 0.29 to 0.75) and Latinos without a place of birth recorded (OR = 0.63, 95% CI = 0.54-0.73).

Conclusion: The prevalence of LCS was low overall in a large sample of Latino and non-Hispanic White patients with cigarette smoking history. Foreign-born Latino and Latino patients without a country of birth noted in the record had significantly lower odds of having LCS ordered; this should be considered in clinical screening workflows. Nativity and pack-year history were not documented in most patients. More complete documentation of nativity and pack-year history is necessary to fully assess LCS need and equity in Latino patients of heterogeneous nativity.