A new lung cancer screening initiative may help to overcome barriers to care among low-income, uninsured, and minority patients residing in Central Texas, according to a recent study published by Pignone et al in the American Journal of Preventive Medicine. The findings represented a critical step toward reducing disparities in lung cancer outcomes.
Background
Lung cancer is one of the deadliest cancer types in the United States, with more than 125,000 deaths expected in 2024. Black, low-income, and less-educated patients are disproportionately affected, facing higher mortality rates.
“Federally Qualified Health Centers like CommUnityCare serve a higher-risk population, making them great places to offer cancer screening and help [patients] quit smoking,” stressed co–study author Brandon Altillo, MD, Assistant Professor of Internal Medicine and Population Health at the Dell Medical School at The University of Texas at Austin and a provider at CommUnityCare Health Centers. “[However], there are still significant barriers, including the cost of screening and limited access to specialists. Many patients also face stress from poverty, which can make it harder to focus on preventive care,” he added.
Study Methods and Results
In the study, researchers used a new screening tool that incorporated a patient-centered approach to identify more than 700 eligible patients (aged 55–77 years) with at least a 20-year history of smoking. The program included bilingual support, mailed outreach materials, no-cost screening to patients, shared decision-making sessions by phone, and patient navigators to help coordinate care. Financial support was also provided for underinsured patients.
From 2020 to 2023, the researchers implemented a multicomponent intervention—an approach designed to promote equitable access to lung cancer screening by removing financial, language, and logistical barriers across the spectrum of care. The researchers found that 83% of the patients who agreed to lung cancer screening completed their low-dose computed tomography scans. There were no statistically significant differences in completion rates by age, gender, race/ethnicity, or insurance status. Further, 49% of current smokers engaged in cessation counseling, and 31% reported quitting.
Conclusions
“Our focus was not just on increasing lung cancer screenings but on ensuring that those most at risk — particularly those with financial or language barriers — could access care,” said Dr. Altillo. “This program demonstrates that with targeted interventions, we can close gaps in health care and save lives.”
Building on its success, the program will expand to reach more Texans, offering both lung cancer screenings and smoking cessation support to high-risk communities.
Disclosure: The program was funded by the Cancer Prevention & Research Institute of Texas. For full disclosures of the study authors, visit ajpmonline.org.
