Disparities in Lung Cancer Screening Availability: Lessons From Southwest Virginia

Background: Little is known about health disparities in access to low-dose computed tomography (LDCT) screening. This study hypothesized that the current capacity for LDCT screening would be exceeded by the number of at-risk individuals in Virginia. Methods: Cancer incidence data and adult smoking rates for Virginia were obtained from public sources between 2006 and 2012. The American College of Radiology website was queried in 2015 to identify lung cancer screening facilities in Virginia, which were surveyed. Spatial exploratory data analysis was used to examine secondary data, and descriptive analysis was used to examine primary survey data. Results: Rural counties have higher lung cancer death rates and smoking rates than metropolitan counties. Despite a tremendous burden for LDCT screening in rural counties, particularly in southwest Virginia, there were only two LDCT facilities. In total, 37 accredited LDCT facilities were identified in Virginia. On average, facilities had been screening for 14.6 months and screened an average of 76 patients. Conclusions: At-risk smokers in Virginia, particularly those living in rural areas with high smoking rates, do not have adequate recommended LDCT coverage. More screening centers are needed to care for the high number of rural smokers at risk for lung cancer.