Abstract Rationale Incidental lung nodule (ILN) programs aim to improve follow-up and early diagnosis of cancer incidentally detected on imaging performed for other reasons. While these programs streamline care and reduce diagnostic delays, differences in lung cancer outcomes persist relative to lung screening (LS) programs. The Area Deprivation Index (ADI), a geographic measure of neighborhood disadvantage based on a based on a patient’s address, has been associated with later-stage cancer diagnoses and reduced access to care. However, it remains unclear whether differences in ADI correlate with observed differences in outcomes for patients diagnosed through an ILN versus a LS program or stage at the time of diagnosis. Methods We conducted a retrospective cohort study of patients enrolled in either the ILN or LS program with a detected nodule or mass or = 6 mm in diameter and diagnosed with intrathoracic cancer over a one-year period within a large academic health system. Demographic, clinical, and cancer staging data were collected manually from the electronic medical record (EMR). National and state-level ADI scores (with scales 1-10 and 1-100, respectively, and higher numbers indicating worse deprivation) were determined for each patient using nine-digit zip code. Statistical analyses included descriptive comparisons for demographic characteristics and median comparisons using Kruskal-Wallis or Wilcoxon rank-sum tests for evaluating the relationship among ADI, cancer stage at diagnosis, and context of diagnosis (ILN vs LS). Results From April 15th, 2024, to April 14th, 2025, 197 patients were diagnosed (ILN n = 97, LS n = 100). ILN patients were older than LS patients (mean ± 71.1±10.9 vs. 67.5 ± 6.5 years), while sex distribution was similar (female 50% vs. 53%). Median ADI was not significantly different between ILN and LS cohorts at the state (ILN 7 IQR 5-8 vs LS 7 5-8; p = 0.6827) or national (ILN 72 IQR 60-83 vs LS 70 57.5-82.5; p = 0.7235) level. For patients with confirmed non-small cell lung cancer (n = 157), Median ADI was not significantly different for patients with stage I/II vs stage III/IV disease at the state (I/II 7 IQR 5-9 vs III/IV 7 5-8; p = 0.6946) or national (I/II 72.5 IQR 56.5-84 vs III/IV 71 61-82; p = 0.8092) level. Conclusion Both programs had similar and high ADI. Area deprivation index alone does not explain observed differences in cancer stage. Further research is needed to identify sociodemographic or frailty indices that explain differences between ILN and LS cancer populations. This abstract is funded by: Atrium Wake Forest Baptist Comprehensive Cancer Prevention and Control Pilot Ignition Funds
Mewborn et al. (Fri,) studied this question.