Community-Based Intervention May Increase Lung Cancer Screening

Cost, lower literacy levels and fear of lung cancer diagnosis were highlighted as concerns with lung cancer screening.

Research presented at the Radiological Society of North America (RSNA) 2021 Annual Meeting describes a community-based outreach intervention that was effective at identifying and addressing barriers to lung cancer screening, such as cost, lower literacy levels and fear of diagnosis.

“Radiologists can partner with patients and key community stakeholders in the development of effective lung cancer screening outreach interventions aimed to increase equitable lung cancer screening participation among low socioeconomic status communities,” the authors wrote.

The results were presented by Efren Jesus Flores, M.D., department of radiology at Massachusetts General Hospital, in Boston.

Community-based lung cancer screening outreach can help individuals from low socioeconomic status communities, who experience worse lung cancer outcomes, by addressing barriers to digital health and promoting trust. In this study, the researchers aimed to develop a tailored digital health outreach intervention to promote lung cancer screening and understand related social needs among low socioeconomic status communities.

Focus groups were conducted at an urban academic medical center with affiliated community health centers with 12 representative primary care physicians, eight advocates, seven lung cancer screening patients and eight non- lung cancer screening patients. Three tailored lung cancer screening outreach video conditions were developed with messaging by a radiologist, patient and patient/radiologist together. 

A national sample of 315 current smokers with Medicaid who were eligible for lung cancer screening were randomized to watch one of the three video messages to determine satisfaction, preferred source, intent to screen and attitudes about lung cancer.

The focus groups cited transportation and fear about lung cancer as major barriers to screening. Patients reported confusion about screening eligibility criteria, the screening process and insurance coverage. The outreach video was modified to emphasize the treatability of early lung cancer, adopted clear language for eligibility and insurance coverage, and displayed a patient undergoing lung cancer screening and receiving results. 

Of the 315 participants, 67% reported satisfaction with the video, with those watching the video messaging from the patient reporting the greatest intent to speak to a physician about lung cancer screening. Participants reported limited social needs.

“Greater social need was associated with significantly lower health literacy, smoking-related stigma, lower confidence in arranging transport to lung cancer screening, greater cost concerns about screening, perceived severity of lung cancer and greater worry about developing lung cancer,” the authors wrote.

For more coverage of RSNA 2021, click here.