National Area of Deprivation Index (ADI) did not significantly differ between lung cancer screening eligible (67) and ineligible (79.5) patients with incidentally detected lung cancers (p=0.39).
Cohort (n=82)
No
Does area of deprivation index (ADI) or clinical stage differ between lung cancer screening eligible and ineligible patients with incidentally detected lung cancers?
ADI and disease stage did not significantly differ between LCS eligible and ineligible patients with incidentally detected lung cancers, though ADI remained high in both groups.
Tasa de eventos absoluta: 67% vs 79.5%
valor p: p=0.39
Abstract Rationale Incidental Lung Nodule (ILN) programs can identify lung cancer in patients who missed, or were ineligible for, lung cancer screening (LCS). However, high missed screenings among ILN patients may result due to healthcare access issues. The area of deprivation index (ADI), a composite value used to measure socioeconomic disadvantage and resource disparity based on geographic residence, has correlated with worse outcomes for lung cancer patients. It is uncertain if ADI differs between screening eligible and ineligible patients with incidentally detected lung cancers, or if ineligibility is associated with more advanced disease at diagnosis. Methods We reviewed ADI, LCS eligibility, and clinical stage in a cohort of newly confirmed primary lung cancers from a centralized ILN program in an academic health system, excluding non-lung metastatic cases. National ADI was assessed using nine-digit zip codes, with higher scores indicating greater socioeconomic disadvantage. LCS screening eligibility was assessed by manual chart review per USPSTF 2021 guidelines. Lung cancers were classified as “early-stage” (stages I, II, or “limited”) or “late-stage” (stages III, IV, or “extensive”). Wilcoxon Rank testing analyzed group differences. Results From April 7, 2024, to April 6, 2025, 82 new primary lung cancer diagnoses were identified through the ILN program. Forty-three patients (52%) were eligible for LCS at the time of ILN detection, 38 (46%) were ineligible, and 1 (1%) had insufficient information to determine eligibility. The national ADI for LCS eligible patients was 67 (CI 60-84) and 79.5 (CI 61-84) for LCS ineligible patients (p = 0.39). Within the LCS eligible cohort, 9 patients (20.9%, CI 10-36%) were “early-stage” whereas 27 (62.8%, CI 46.7-77%) were “late-stage.” The LCS ineligible cohort was comprised of 15 patients (39.5% CI 24-56.6%) as “early-stage” whereas 21 (55.3%, CI 38.3%-71.4%) were classified as “late-stage” (p = 0.10). For LCS ineligibility, age (n = 19, n = 1 50 years old, n = 18 80 years old, 50%) followed by quit length greater than 15 years (n = 17, 44.7%) were the most significant contributors. Assessing smoking history, 24 of the 38 ineligible patients (63.2%) were former smokers. Conclusions ADI or disease stage was not significantly different between LCS eligible and ineligible patients, yet ADI remains high among incidentally detected cancers. Revising USPSTF 2021 screening cutoffs for years since quitting could enhance high-risk patient identification for LCS screening given the elevated former smoking rates among LCS ineligible patients. Average ADI: LCS eligible (67) vs ineligible (79.5) among new lung cancer diagnoses within the centralized ILN program. This abstract is funded by: Lung Cancer Initiative of North Carolina
Davda et al. (Fri,) conducted a cohort in Primary lung cancer (n=82). Lung cancer screening eligibility vs. Lung cancer screening ineligibility was evaluated on National Area of Deprivation Index (ADI) (p=0.39). National Area of Deprivation Index (ADI) did not significantly differ between lung cancer screening eligible (67) and ineligible (79.5) patients with incidentally detected lung cancers (p=0.39).