WCLC 2025 - Posters & ePosters-P3.01.26 Respiratory Hazard Index Is Associated With Lung Cancer Development in Underrepresented Lung Cancer Screening Individuals

P3.01.26 Respiratory Hazard Index Is Associated With Lung Cancer Development in Underrepresented Lung Cancer Screening Individuals

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This study investigates factors associated with lung cancer (LC) development among underrepresented individuals undergoing lung cancer screening (LCS) via low-dose computed tomography (LDCT) at the University of Illinois Health (UI Health), a minority-serving academic health system in Chicago. Among 2,645 screened participants (2010-2024), 3.6% (96) developed lung cancer, a higher rate than the typical ~1% observed in general LCS programs.<br /><br />Key findings include significant clinical and social determinants of health (SDOH) associated with increased cancer risk. Individuals with lung cancer had lower baseline BMI (mean 25.9 vs. 29.0), were more likely to live alone (36.5% vs. 20.2%), and had a higher prevalence of family history of lung cancer (31.3% vs. 13.0%). Lung-RADS category 4 scores, indicating suspicious screening results, were much more common in the cancer group (69.8% vs. 8.6%). Non-Hispanic White ethnicity was proportionally higher in cancer cases (22.9% vs. 15.2%).<br /><br />Geospatial analyses linked environmental exposures to cancer risk. The Respiratory Hazard Index (RHI), reflecting air toxic exposures, was modestly but significantly elevated in cancer patients at community, zip code, and census levels (p = 0.034 at zip code level). Logistic regression showed lung-RADS 3 or higher conferred over 10-fold increased odds of cancer diagnosis, and living alone nearly doubled odds. Higher RHI showed a trend toward increased cancer risk (OR 1.69, p=0.063).<br /><br />The study highlights that environmental hazards and social inequities contribute to elevated lung cancer risk in underrepresented populations. It advocates integrating environmental SDOH such as air pollution exposure and housing instability into lung cancer screening protocols and prevention strategies. This integrative approach may improve early detection and address health disparities in minority communities disproportionately affected by lung cancer.

Asset Subtitle

Frank Weinberg

Meta Tag

Speaker Frank Weinberg

Topic Risk Factors, Risk Reduction & Tobacco Control

Keywords

lung cancer

lung cancer screening

low-dose computed tomography

underrepresented populations

social determinants of health

Respiratory Hazard Index

environmental exposures

lung-RADS

health disparities

minority-serving health system