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Jed Gorden



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    EP1.11 - Screening and Early Detection (ID 201)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Screening and Early Detection
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.11-12 - Lung Cancer Screening: Implementation in a Multi-State, Community-Based Setting (Now Available) (ID 2755)

      08:00 - 18:00  |  Author(s): Jed Gorden

      • Abstract
      • Slides

      Background

      The benefits of lung cancer screening (LCS) was largely proven in academic centers, and while implementation in the Veterans Health Administration has been reported, little data has been published on the broader community experience. We aimed to describe the LCS implementation experience in a multi-state, community-based healthcare network.

      Method

      We reviewed individuals who were referred for LCS between 01/01/2012-03/31/2017 within our community-based network of 12 LCS programs spanning 22 LCS sites in Alaska, Montana, Oregon and Washington. One of the programs is considered centralized (shared decision making, evaluation and management occur at a single site) and 11 are considered decentralized (shared decision making, evaluation and management occur in geographically diverse community care settings with support from a central LCSP coordinator). 2013 Rural-Urban Continuum Codes from the United States Department of Agriculture were used to determine metropolitan/non-metropolitan/rural status.

      Result

      Data collection is complete for 4,820 of the total 6,451 individuals, of which 9% (450/4,820) were excluded for being outside the age and smoking history LCS criteria range. A further 908 were excluded for other reasons. Thus, the preliminary results of 3,462 individuals are included here. Characteristics of the individuals are shown in the table. Of the 22 LCS sites 82% (18) were located in metropolitan areas, 18% (4) in non-metropolitan areas and none in rural areas. The distribution of screened individuals and LCS centers within the healthcare network are shown in the figure.

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      Conclusion

      Screening in the community setting remains in metropolitan areas. Positive findings on the initial scan are common; however, intervention rates are low. Retention for screening also remains high.

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    P1.11 - Screening and Early Detection (ID 177)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Screening and Early Detection
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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      P1.11-29 - Relationship Between Lung Cancer Screening Centers in the United States and High-Risk Individuals (Now Available) (ID 2861)

      09:45 - 18:00  |  Author(s): Jed Gorden

      • Abstract
      • Slides

      Background

      Lung cancer screening center (LCSC) numbers are increasing. The location of LCSCs relative to the geographic distribution of the highest-risk lung cancer populations has not been determined. We aimed to determine the distribution of at-risk populations, and their geographic relationship to LCSCs registered with the American College of Radiology (ACR).

      Method

      Population statistics datasets were obtained from the 2016 American Community Survey and Behavior Risk Factor Surveillance System. Due to differences between the two datasets, weighting and propensity matching was performed to obtain a weighted population of 477,665 individuals matched by age/race/education/income with merged smoking data. The proportion of the state population at-risk for lung cancer was calculated by two Risk Categories - RC1: 55-77 years/current-former smoker; and RC2: 55-77 years/current-former smoker/<=high school/income<$35,000/African American-American Indian. These were mapped and the 3,910 ACR-registry LCSCs superimposed. Pearson Correlation Coefficient (PCC) between at-risk populations and number of LCSCs per state was calculated. A cluster analysis based on risk characteristics categorized states into three risk groups: G1–baseline, G2 - >RC1 individuals, G3 - >RC2 individuals. Rural-Urban Continuum Codes determined metropolitan/non-metropolitan/rural status.

      Result

      The national distribution of RC1 and RC2 individuals in relation to LCSCs shown in figure 1. There was no correlation between the proportion of at-risk populations and number of LCSCs [PCC for RC1=-0.23; PCC for RC2=-0.03]. Although clustering identified states with significantly different risk groups, there was no difference in the number LCSCs between the groups [median(IQR) G1=60(70), G2=75(103), G3=49(110); p=0.684] (figure 2). Of the LCSCs, 83% (3,245) were in metropolitan counties, 12% (469) in non-metropolitan and 5% (196) in rural.

      figure a-b.jpg

      figure 2a-b.jpg

      Conclusion

      LCSCs are not evenly distributed at the national/state/county level. There is also no significant correlation between the proportion of at-risk populations and LCSCs, even though some states have higher proportions of at-risk populations. The distribution of LCSCs may be important to LCS access.

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