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Challenges Implementing Lung Cancer Screening in Federally Qualified Health Centers
Journal article   Open access   Peer reviewed

Challenges Implementing Lung Cancer Screening in Federally Qualified Health Centers

Steven B. Zeliadt, Richard M. Hoffman, Genevieve Birkby, Jan M. Eberth, Alison T. Brenner, Daniel S. Reuland and Susan A. Flocke
American journal of preventive medicine, v 54(4), pp 568-575
01 Apr 2018
DOI: https://doi.org/10.1016/j.amepre.2018.01.001
PMID: 29429606
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://europepmc.org/articles/pmc8483158?pdf=renderView
Accepted (AM)Open Access (License Unspecified),  Open

Abstract

General & Internal Medicine Life Sciences & Biomedicine Medicine, General & Internal Public, Environmental & Occupational Health Science & Technology
Introduction: The purpose of this study is to identify issues faced by Federally Qualified Health Centers (FQHCs) in implementing lung cancer screening in low-resource settings. Methods: Medical directors of 258 FQHCs serving communities with tobacco use prevalence above the median of all 1,202 FQHCs nationally were sampled to participate in a web-based survey. Data were collected between August and October 2016. Data analysis was completed in June 2017. Results: There were 112 (43%) FQHC medical directors or surrogates who responded to the 2016 survey. Overall, 41% of respondents were aware of a lung cancer screening program within 30 miles of their system's largest clinic. Although 43% reported that some providers in their system offer screening, it was typically at a very low volume (less than ten/month). Although FQHCs are required to collect tobacco use data, only 13% indicated that these data can identify patients eligible for screening. Many FQHCs reported important patient financial barriers for screening, including lack of insurance (72%), preauthorization requirements (58%), and out-of-pocket cost burdens for follow-up procedures (73%). Only 51% indicated having adequate access to specialty providers to manage abnormal findings, and few reported that leadership had either committed resources to lung cancer screening (12%) or prioritized lung cancer screening (12%). Conclusions: FQHCs and other safety-net clinics, which predominantly serve low-socioeconomic populations with high proportions of smokers eligible for lung cancer screening, face significant economic and resource challenges to implementing lung cancer screening. Although these vulnerable patients are at increased risk for lung cancer, reducing patient financial burdens and appropriately managing abnormal findings are critical to ensure that offering screening does not inadvertently lead to harm and increase disparities. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine

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56 citations in Web of Science
59 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Public, Environmental & Occupational Health
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