Elevated lung cancer screening needs among emergency department patients

Background

More than 10 % of Emergency Department (ED) cancer-related visits are for lung cancer. Timely lung cancer screening is an effective mechanism to decrease lung cancer morbidity and mortality, but only 16 % of eligible patients in the general population are up-to-date with lung cancer screening recommendations. Furthermore, many characteristics found predictive of non-adherence with screening are over-represented within the ED patient population.

Objective

The goal of this study is to determine risk for non-adherence with USPSTF lung cancer screening guidelines among the ED patient population.

Methods

Data on smoking history and lung cancer screening were abstracted from the medical charts of patients 50–80 years old presenting to the University of Rochester Medical Center ED during 2023. Adherence with guidelines among eligible patients was determined by documentation of lung cancer screening in the year prior to ED presentation. We also evaluated any screening that occurred within 120 days of their ED visit.

Results

A total of 559 patient charts were reviewed, with 354 having a documented history of tobacco use (63 %). Pack year estimates were available for 252 patients, and 116 patients had a 20+ pack year smoking history documented (e.g., eligible for lung cancer screening). Among those, 14 individuals received LCS in the past year, representing a screening adherence rate of 12 % at presentation. By 120 days post-visit, the rate declined to 9 %.

Conclusion

ED patients are at elevated risk for non-adherence with LCS guidelines, supporting previous work that demonstrates the potential value of ED-based intervention efforts.