Mobile Lung Cancer Screening in an Underserved Population Finds High Incidence of Concurrent Disease States

Based on evidence showing survival benefit for low-dose computerized tomographic (LDCT) lung cancer screening in high-risk smokers, a mobile LDCT lung screening program for underserved populations was initiated by the Levine Cancer Institute. Findings from this program were reported at the ASCO 2021 meeting.

From May 2017 to December 2020, eligible subjects were identified and underwent LDCT screening for lung cancer detection. All subjects screened were uninsured or had Medicaid, with a mean age of 60.8 years and an overall 47.1 mean pack-year smoking history; 18% of screened subjects were African American, 3% were of Latin ethnicity, and 78% belonged to rural communities. All subjects underwent screening with CT scans, which were reviewed by 2 separate radiologists and a separate expert multidisciplinary team.

By December 2020, a total of 1198 subjects completed their first screening. Of those screened, the majority of subjects (84%; n = 1006) were found to have at least 1 incidental comorbid condition. Overall, the most common disease finding was coronary atherosclerosis (54%; n = 645), followed by emphysema (42%; n = 504) and vascular atherosclerotic disease (25%; n = 299). Of the 645 subjects with coronary atherosclerosis, 25% (n = 183) had at least moderate disease and 8% (n = 96) had severe disease. Other common disease findings were degenerative spine changes (n = 205), cholelithiasis (n = 59), hiatal hernia (n = 52), pericardial effusions (n = 38), fatty liver (n = 32), kidney stone (n = 3), and cardiomegaly (n = 30). An additional 3.5% of subjects (n = 42) had solid organ masses, including breast, adrenal, liver, or kidney lesions, that required diagnostic workup.

The findings of the mobile LDCT lung screening program revealed a high number of incidental disease findings in a rural underserved high-risk population of heavy smokers, providing an opportunity for early intervention for other comorbid conditions in addition to lung cancer.

Source: Carrizosa DR, et al. J Clin Oncol. 2021;39(suppl 15):Abstract 6540.