The association of urbanicity and travel time with lung cancer screening utilization |
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| Affiliation: | 1. Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA;2. Center for Integrative Oncology & Survivorship, Prisma Health, 900 W Faris Rd 1st Floor, Greenville, SC 29605, USA;3. Clemson Center for Geospatial Technologies, Clemson University Libraries, 116 Sigma Drive, Clemson, SC 29634, USA;1. Department of Internal Medicine, Jackson Memorial Hospital / University of Miami Health System, FL, USA;2. The Population Registry of Cancer of the Metropolitan Area of Bucaramanga, Universidad Autónoma de Bucaramanga, Colombia;3. Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia;4. University of Miami Miller School of Medicine and Sylvester Comprehensive Cancer Center, FL, USA;1. Faculty of Pharmacy, Universidade Federal de Minas Gerais, Brazil;2. Ezequiel Dias Foundation, Brazil;3. Hospital das Clínicas, Universidade Federal de Minas Gerais, Brazil;1. Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA;2. Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA;1. Department of Radiotherapy, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Pernambuco, Brazil;2. Department of Education and Research, Hospital de Câncer de Pernambuco, Recife, Pernambuco, Brazil;3. Department of Head and Neck Surgery, Hospital de Câncer de Pernambuco, Recife, Pernambuco, Brazil;4. Department of Oncology, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Pernambuco, Brazil;5. Department of Pneumology, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Pernambuco, Brazil;6. Clinical Research Division, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Pernambuco, Brazil;1. Clinical Oncology Department, Faculty of Medicine, Assiut University, Assiut, Egypt;2. Clinical Pathology Department, Faculty of Medicine, Assiut University, Assiut, Egypt;1. National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil;2. Health Technology Management Coordination, National Health Agency, Rio de Janeiro, Brazil;3. Department of Epidemiology and Quantitative Methods, National Public Health School, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil |
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| Abstract: | BackgroundTo examine 1) the rate of lung cancer screening (LCS) utilization in a large healthcare system in South Carolina; 2) associations of urbanicity and travel time with LCS utilization.MethodsLCS-eligible patients from 2019 were identified. The outcome was LCS utilization. The exposures were zip-code level urbanicity and travel time from the centroid of zip-code area to the nearest screening site (<10,10-<20, ≥20 min). Covariates included age, sex, race, marital status, insurance, body mass index, chronic obstructive pulmonary disease, Charlson Comorbidity Index (0, 1, 2, ≥3), and zip-code level median income. Chi-square tests and logistic regressions were employed.ResultsThe analysis included 6930 patients, among whom 1432 (20.66%) received LCS. After adjusting for covariates, living in a non-metropolitan area (adjusted odds ratio: 0.32; 95% confidence interval: 0.26–0.40) and having longer travel time (0.80 [0.65–0.98] and 0.68 [0.54–0.86] for 10-<20 and ≥20 min travel time, respectively, compared to <10 min travel time) were significantly associated with lower odds of LCS utilization.ConclusionsThe LCS utilization rate of a healthcare system was about 20% in 2019. Living in non-metropolitan areas or having longer travel time to LCS site were associated with lower LCS utilization. |
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| Keywords: | Lung cancer screening Travel time Metropolitan areas Electronic health records |
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