Asian-Americans in a Lung Cancer Screening Program Have Lower Annual Adherence Compared with Other Race Groups

Background Racial differences in lung cancer screening (LCS) eligibility and outcomes persist despite recent expansion of the US Preventive Services Task Force criteria and greater recognition of screening disparities. Research Question What is the annual screening adherence rate for USPSTF-eligible Asian-Americans receiving LCS through a centralized screening program? Study Design and Methods Individuals screened through a centralized LCS Program were identified retrospectively using the Jefferson LCS Program Registry. Sociodemographic and clinical data were extracted from the prospectively maintained Registry. Frequency statistics were compared by race including among Asian-American subgroups, and multivariate logistic regression was carried out for annual adherence with LCS. Results Among 2,257 individuals in the study cohort, 122 participants (5.4%) self-identified their race as Asian-American. Compared to other race groups, Asian-Americans had significant differences in gender distribution, educational attainment, and insurance status. The most common Asian-American race subgroups were Chinese-American, Korean-American, and Vietnamese-American, and significant differences in cigarette smoking intensity were seen between these groups. Among currently smoking individuals, Asian-Americans reported interest in tobacco counseling and pharmacotherapy treatment at rates similar to those of other races. Asian-American individuals had significantly lower odds of adherence (aOR 0.42; 95%CI, 0.26-0.69) with annual screening compared with other races, even after adjustment for age, gender, educational attainment, smoking status, and chronic obstructive pulmonary disease. Interpretation Asian-Americans in our centralized LCS Program have increased rates of lung cancer risk factors including low educational attainment, high smoking prevalence, low tobacco cessation, and low annual LCS adherence compared with other race groups. This gap highlights the need for greater focus on culturally tailored early detection strategies for this underserved population.