Lung Cancer Screening for the Poor and Underserved: Should Routine Screening be Performed?

Background: Lung cancer is a leading cause of death in United States. A recent study using low dose CT scans for screening long term smokers for lung cancer has, for the first time, demonstrated reduction in mortality, although it is not a standard of care in the community yet.

Method: We analyzed lung cancer data for stages 0 through 4 for 1,412 individuals from, a public hospital, Nassau University Medical Center (NUMC) with patients of lower income, two private hospitals, North Shore University Hospital (NSUH) and Long Island Jewish Hospital (LIJ), with patients of higher income, with average household income per year of 83,795 $, 152,777 $ and 93,234 $ respectively.

Result: Significantly smaller percentages of patients were diagnosed with stages 0 and 1 lung cancer at NUMC (8.55%) versus either NSUH (36.18%, P < 0.001) or LIJ (35.70%, (P < 0.001).

Conclusion: At this point there is evidence that Lung Cancer Screening reduces mortality in long term smokers, but there is debate over, if it should be made into a recommendation. In light of the above study we suggest, that screening for lower socioeconomic class, could be recommended, if not for general population.