Annual Adherence of Asian American Individuals in a Lung Cancer Screening Program Compared With Other Racial Groups

Background

Racial differences in lung cancer screening (LCS) eligibility and outcomes persist despite recent expansion of the US Preventive Services Task Force criteria and greater recognition of screening disparities.

Research Question

What is the annual screening adherence rate for US Preventive Services Task Force-eligible Asian American individuals receiving LCS through a centralized screening program?

Study Design and Methods

Individuals screened through a centralized LCS program were identified retrospectively using the Jefferson LCS Program Registry. Sociodemographic and clinical data were extracted from the prospectively maintained registry. Frequency statistics were compared by race including among Asian American subgroups, and multivariate logistic regression was carried out for annual adherence with LCS.

Results

Among 2,257 individuals in the study cohort, 122 participants (5.4%) self-identified their race as Asian American. Compared with other racial groups, Asian American individuals had significant differences in sex distribution, educational attainment, and insurance status. The most common Asian American race subgroups were Chinese American, Korean American, and Vietnamese American, and significant differences in cigarette smoking intensity were seen between these groups. Among currently smoking individuals, Asian American individuals reported interest in tobacco counseling and pharmacotherapy treatment at rates similar to those of other races. Asian American individuals had significantly lower odds of adherence (adjusted OR, 0.42; 95% CI, 0.26-0.69) with annual screening than other races, even after adjustment for age, sex, educational attainment, smoking status, and COPD.

Interpretation

Asian American individuals in our centralized LCS program have increased rates of lung cancer-related factors including low educational attainment, high smoking prevalence, low tobacco cessation, and low annual LCS adherence compared with other racial groups. This gap highlights the need for greater focus on culturally tailored early detection strategies for this underserved population.