WCLC 2025 - Posters & ePosters-P1.04.04 Effect of Social Determinants of Health on Lung Cancer Screening Uptake in the U.S

Pdf Summary

This study investigated the impact of cumulative social determinants of health (SDOH) on lung cancer screening (LCS) uptake in the United States, utilizing data from 14,583 individuals eligible for screening per the 2021 USPSTF guidelines, drawn from the 2022-2023 Behavioral Risk Factor Surveillance System (BRFSS). Researchers developed composite SDOH scores via item response theory from 11 variables spanning social, economic, environmental, and healthcare affordability domains.<br /><br />Lung cancer screening by low dose computed tomography (LDCT) reduces mortality but remains underutilized in the US. Prior research has linked individual negative social determinants with lower screening rates. The study hypothesized that a greater cumulative SDOH burden would correlate with reduced LCS.<br /><br />Logistic regression models adjusted for demographics and insurance status found no significant association between composite SDOH scores and up-to-date lung cancer screening overall (OR 0.99; 95% CI 0.88–1.11), nor within subgroups stratified by age, sex, or race/ethnicity. Analysis by SDOH quartiles also failed to reveal significant differences in screening rates. These findings suggest cumulative social risk as measured here does not predict LCS uptake.<br /><br />The authors recommend future research to examine multilevel influences beyond individual social factors, including health system-level variables such as patient navigation and facility access, and neighborhood-level factors like area deprivation and transportation infrastructure, to better understand barriers to lung cancer screening.<br /><br />In summary, while individual social determinants impact health behaviors, this study’s composite SDOH measure showed no significant effect on lung cancer screening rates in the US population studied. Addressing broader systemic and contextual factors may be necessary to improve lung cancer screening utilization and reduce disparities.

Asset Subtitle

Elizabeth Seitz

Meta Tag

Speaker Elizabeth Seitz

Topic Screening and Early Detection

Keywords

lung cancer screening

social determinants of health

SDOH composite score

low dose computed tomography

LDCT

USPSTF guidelines

Behavioral Risk Factor Surveillance System

lung cancer mortality

health disparities

multilevel influences