Geographic access to lung cancer screening and environmental lung cancer risk factors in the contiguous United States
Year: 2025
Type: article
Abstract: Objective Lung cancer is the leading cause of cancer mortality in the U.S., and worldwide. We examined the association between geographic access to lung cancer screening facilities (LCSF) and geographically distributed lung cancer risk factors – fine particulate matter (PM 2.5 ) and indoor radon levels in the contiguous U.S. Methods We estimated geographic access to LCSF using facility information from the American College of Radiology, Lung Cancer Screening Registry and the enhanced two-step floating catchment area method. Census tract level PM 2.5 and county level radon data were obtained from the U.S. EPA. We examined whether PM 2.5 and radon predicted geographic access to LCSF using a linear mixed effects model with random intercepts for counties, adjusting for smoking prevalence and other factors, and testing for modification by urban-rural area. Results We found higher geographic access to LCSF in counties with moderate and high radon levels, and census tracts with higher levels of PM 2.5 , with significant modification by urban-rural areas. Discussion Our results suggest that accessibility to LCSF in the U.S. is generally aligned with environmental risk factors for lung cancer, with the exception of micropolitan areas or small cities, where higher PM 2.5 areas had lower screening access. It is worth considering how environmental risk factors may be incorporated into lung cancer screening programs.
Source: Health & Place
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,380
OpenAlex ID: W4416827225