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Increasing Lung Cancer Screening for High-Risk Smokers in a Frontier Population

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Abstract

Northern Plains American Indians (AIs) have some of the highest smoking and lung cancer mortality rates in the USA. They are a high-risk population in which many are eligible for low-dose computed tomography (LDCT) screening, but such screening is rarely used. This study investigated methods to increase LDCT utilization through both a provider and community intervention to lower lung cancer mortality rates. This study used the Precaution Adoption Model for provider and community interventions implemented in four study regions in western South Dakota. The goal was to increase LDCT screening for eligible participants. Intake surveys and LDCT screenings were compared at baseline and 6 months following the education programs for both interventions. A total of 131 providers participated in the provider intervention. At the 6-month follow-up survey, 31 (63%) referred at least one patient for LDCT (p < 0.05). Forty (32.3%) community participants reported their provider recommended an LDCT and of those, 30(75%) reported getting an LDCT (p < 0.05). A total of 2829 patient surveys were completed at the imaging sites and most (88%, n = 962) cited provider recommendation as their reason for obtaining an LDCT. Almost half (46%; n = 131) of the referring providers attended a provider education workshop, and 73% of the providers worked at a clinic that hosted at least one community education session. Over the study period, LDCT utilization increased from 640 to 1706, a 90.9% increase. The provider intervention had the strongest impact on LDCT utilization. This study demonstrated increased LDCT utilization through the provider intervention but increases also were documented for the other intervention combinations. The community-based education program increased both community and provider awareness on the value of LDCTs to lower lung cancer mortality rates.

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Funding

This study was supported by Bristol Myers Squib Foundation.

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Authors and Affiliations

  1. University of Kentucky, 760 Press Avenue, Room 335, Lexington, KY, 40536-0679, USA

    Mark Dignan

  2. Avera Research Institute, Rapid City, SD, 57701, USA

    Kristin Cina, Michele Sargent, Margaret O’Connor, Romaine Tobacco & Daniel Petereit

  3. Native American Cancer Research Corporation, Pine, CO, 80470, USA

    Linda Burhansstipanov

  4. Ubicomp Lab, Marquette University, Milwaukee, WI, 53201, USA

    Sheikh Ahamed

  5. Dakota Radiology, Rapid City, SD, 57701, USA

    David White

  6. Monument Health Cancer Care Institute, Rapid City, SD, 57701, USA

    Daniel Petereit

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Correspondence to Mark Dignan.

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Dignan, M., Cina, K., Sargent, M. et al. Increasing Lung Cancer Screening for High-Risk Smokers in a Frontier Population. J Canc Educ 39, 27–32 (2024). https://doi.org/10.1007/s13187-023-02369-7

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