Abstract C152: Bronchoscopy-informed recruitment to enhance equity in lung cancer clinical research: A pilot initiative at Novant Health oncology clinical research

Background: Lung cancer remains the leading cause of cancer-related mortality in the United States, with particularly high incidence and death rates among Black/African American individuals and those from lower socioeconomic backgrounds. These groups are more likely to be diagnosed at later stages, face treatment delays, and are consistently underrepresented in clinical trials. One contributing factor is limited access to low-dose CT (LDCT) screening programs, which often serve as the primary recruitment pipeline for thoracic oncology research. This disparity highlights an urgent need for alternative strategies that broaden research access and promote equitable inclusion. Methods: To address this gap, our thoracic oncology research team at Novant Health implemented a pilot initiative in early 2025 to leverage bronchoscopy data as an additional patient identification pathway. Bronchoscopy is commonly performed in diagnostic workups for symptomatic individuals or those with abnormal imaging findings. We developed an integrated workflow to systematically review bronchoscopy reports in real time. Clinical research coordinators partnered with pulmonologists and thoracic oncologists to evaluate eligibility and offer research participation to appropriate candidates. Preliminary Findings: Bronchoscopy-informed identification captures a broader, more diverse subset of patients. Several individuals flagged through this method would not have qualified under existing LDCT screening criteria but were found to have significant pathology, including early-stage lung cancer and smoking-related comorbidities such as COPD and interstitial lung disease. A notable proportion of these patients self-identified as belonging to racial or ethnic minority groups or were uninsured or underinsured. Conclusion: Integrating bronchoscopy-informed recruitment into standard clinical research workflows offers a feasible, scalable, and impactful approach to improving health equity in lung cancer care and research. This pilot initiative suggests that expanding beyond LDCT-centric strategies may help overcome structural barriers that limit trial access among medically underserved populations. Continued data collection will evaluate long-term feasibility, patient outcomes, and potential scalability across cancer types and health systems. Citation Format: Amnazo Muhirwa, Garrett Sherwood, Hannah Palmer, Latifa Gilmore. Bronchoscopy-informed recruitment to enhance equity in lung cancer clinical research: A pilot initiative at Novant Health oncology clinical research [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C152.