Lung Cancer Screening Eligibility, Uptake, and Adherence in Puerto Rico, 2022
Importance: Lung cancer screening (LCS) with yearly low-dose computed tomography reduces lung cancer mortality, but uptake remains low. Puerto Rico, a U.S. territory, faces significant barriers to LCS implementation, but data on LCS eligibility and use are limited. Objective: This study aimed to est...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-08-01
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| Series: | JTO Clinical and Research Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666364325000694 |
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| author | Maira A. Castañeda-Avila, PhD, MS Eduardo J. Santiago-Rodríguez, PhD, MPH William Rodríguez-Cintrón, MD, MPH Coral Olazagasti, MD Efrén J. Flores, MD Estelamari Rodríguez, MD, MPH Ana I. Velázquez Mañana, MD, MSc Yomayra Otero-Domínguez, MD, MS Eduardo R. Núñez, MD, MS |
| author_facet | Maira A. Castañeda-Avila, PhD, MS Eduardo J. Santiago-Rodríguez, PhD, MPH William Rodríguez-Cintrón, MD, MPH Coral Olazagasti, MD Efrén J. Flores, MD Estelamari Rodríguez, MD, MPH Ana I. Velázquez Mañana, MD, MSc Yomayra Otero-Domínguez, MD, MS Eduardo R. Núñez, MD, MS |
| author_sort | Maira A. Castañeda-Avila, PhD, MS |
| collection | DOAJ |
| description | Importance: Lung cancer screening (LCS) with yearly low-dose computed tomography reduces lung cancer mortality, but uptake remains low. Puerto Rico, a U.S. territory, faces significant barriers to LCS implementation, but data on LCS eligibility and use are limited. Objective: This study aimed to estimate the number of individuals eligible for LCS in Puerto Rico and assess the prevalence of LCS use and up-to-date status compared with U.S. Hispanic and non-Hispanic populations. Design, Setting, and Participants: This cross-sectional study analyzed data from the 2022 Behavioral Risk Factor Surveillance System, a population-based telephone survey. Adults eligible for LCS per 2021 U.S. Preventive Services Task Force guidelines (aged 50–80 years, ≥20 pack-year smoking history, current or recent smokers) from Puerto Rico and the United States were included. Exposures: Participants were categorized into three groups: Puerto Rico residents, U.S. Hispanic, and U.S. non-Hispanic populations. Primary Outcomes and Measures: The primary outcomes and measures were self-reported receipt of initial LCS (ever had chest CT for screening) and being up to date with LCS (i.e., chest CT in the past year). Multivariable Poisson models estimated adjusted prevalence ratios for LCS outcomes. Results: After population weighting, 94,955 individuals were eligible for LCS in Puerto Rico, compared with 12.8 million in the U.S., representing 7.9% and 11.9% of their respective populations. The prevalence of self-reported LCS use was 28.4% in Puerto Rico, 27.6% among U.S. Hispanics, and 31.5% among U.S. non-Hispanics. Being up to date with LCS was lower among Puerto Rico residents (9.8%) than among U.S. Hispanics (17.3%) and non-Hispanics (18.1%). Multivariable models found Puerto Rico residents were less likely to be up to date with LCS than were U.S. non-Hispanics (adjusted prevalence ratios, 0.54; 95% CI 0.29–0.99). Conclusions and Relevance: Fewer than 10% of eligible individuals in Puerto Rico self-reported being up to date with LCS, indicating they are almost half as likely to self-report as eligible individuals in the United States, highlighting significant gaps in care. Implementing high-quality LCS in Puerto Rico is critical to reducing lung cancer mortality and providing equitable lung cancer care. |
| format | Article |
| id | doaj-art-3643bd19fda040fb9b73d3519417bed4 |
| institution | Kabale University |
| issn | 2666-3643 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTO Clinical and Research Reports |
| spelling | doaj-art-3643bd19fda040fb9b73d3519417bed42025-08-20T03:39:05ZengElsevierJTO Clinical and Research Reports2666-36432025-08-016810085210.1016/j.jtocrr.2025.100852Lung Cancer Screening Eligibility, Uptake, and Adherence in Puerto Rico, 2022Maira A. Castañeda-Avila, PhD, MS0Eduardo J. Santiago-Rodríguez, PhD, MPH1William Rodríguez-Cintrón, MD, MPH2Coral Olazagasti, MD3Efrén J. Flores, MD4Estelamari Rodríguez, MD, MPH5Ana I. Velázquez Mañana, MD, MSc6Yomayra Otero-Domínguez, MD, MS7Eduardo R. Núñez, MD, MS8Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts; Corresponding author. Address for correspondence: Maira A. Castañeda-Avila, PhD, MS, 55 Lake Avenue North, Worcester 01655, Massachusetts.Division of Cancer Prevention, National Cancer Institute, Rockville, Maryland; Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MarylandDivision of Pulmonary and Critical Care, San Juan VA Medical Center, San Juan, Puerto RicoDivision of Medical Oncology, University of Miami Miller School of Medicine, Miami, FloridaDepartment of Radiology, Massachusetts General Hospital, Boston, MassachusettsDivision of Medical Oncology, University of Miami Miller School of Medicine, Miami, FloridaDivision of Hematology/Oncology, University of California at San Francisco–School of Medicine, San Francisco, CaliforniaDivision of Pulmonary and Critical Care, San Juan VA Medical Center, San Juan, Puerto RicoDepartment of Medicine, University of Massachusetts Chan Medical School-Baystate, Springfield, Massachusetts; Department of Healthcare Delivery and Population Sciences, University of Massachusetts Chan Medical School-Baystate, Springfield, MassachusettsImportance: Lung cancer screening (LCS) with yearly low-dose computed tomography reduces lung cancer mortality, but uptake remains low. Puerto Rico, a U.S. territory, faces significant barriers to LCS implementation, but data on LCS eligibility and use are limited. Objective: This study aimed to estimate the number of individuals eligible for LCS in Puerto Rico and assess the prevalence of LCS use and up-to-date status compared with U.S. Hispanic and non-Hispanic populations. Design, Setting, and Participants: This cross-sectional study analyzed data from the 2022 Behavioral Risk Factor Surveillance System, a population-based telephone survey. Adults eligible for LCS per 2021 U.S. Preventive Services Task Force guidelines (aged 50–80 years, ≥20 pack-year smoking history, current or recent smokers) from Puerto Rico and the United States were included. Exposures: Participants were categorized into three groups: Puerto Rico residents, U.S. Hispanic, and U.S. non-Hispanic populations. Primary Outcomes and Measures: The primary outcomes and measures were self-reported receipt of initial LCS (ever had chest CT for screening) and being up to date with LCS (i.e., chest CT in the past year). Multivariable Poisson models estimated adjusted prevalence ratios for LCS outcomes. Results: After population weighting, 94,955 individuals were eligible for LCS in Puerto Rico, compared with 12.8 million in the U.S., representing 7.9% and 11.9% of their respective populations. The prevalence of self-reported LCS use was 28.4% in Puerto Rico, 27.6% among U.S. Hispanics, and 31.5% among U.S. non-Hispanics. Being up to date with LCS was lower among Puerto Rico residents (9.8%) than among U.S. Hispanics (17.3%) and non-Hispanics (18.1%). Multivariable models found Puerto Rico residents were less likely to be up to date with LCS than were U.S. non-Hispanics (adjusted prevalence ratios, 0.54; 95% CI 0.29–0.99). Conclusions and Relevance: Fewer than 10% of eligible individuals in Puerto Rico self-reported being up to date with LCS, indicating they are almost half as likely to self-report as eligible individuals in the United States, highlighting significant gaps in care. Implementing high-quality LCS in Puerto Rico is critical to reducing lung cancer mortality and providing equitable lung cancer care.http://www.sciencedirect.com/science/article/pii/S2666364325000694Lung cancer screeningPuerto RicoCancer disparitiesHispanic or Latino health |
| spellingShingle | Maira A. Castañeda-Avila, PhD, MS Eduardo J. Santiago-Rodríguez, PhD, MPH William Rodríguez-Cintrón, MD, MPH Coral Olazagasti, MD Efrén J. Flores, MD Estelamari Rodríguez, MD, MPH Ana I. Velázquez Mañana, MD, MSc Yomayra Otero-Domínguez, MD, MS Eduardo R. Núñez, MD, MS Lung Cancer Screening Eligibility, Uptake, and Adherence in Puerto Rico, 2022 JTO Clinical and Research Reports Lung cancer screening Puerto Rico Cancer disparities Hispanic or Latino health |
| title | Lung Cancer Screening Eligibility, Uptake, and Adherence in Puerto Rico, 2022 |
| title_full | Lung Cancer Screening Eligibility, Uptake, and Adherence in Puerto Rico, 2022 |
| title_fullStr | Lung Cancer Screening Eligibility, Uptake, and Adherence in Puerto Rico, 2022 |
| title_full_unstemmed | Lung Cancer Screening Eligibility, Uptake, and Adherence in Puerto Rico, 2022 |
| title_short | Lung Cancer Screening Eligibility, Uptake, and Adherence in Puerto Rico, 2022 |
| title_sort | lung cancer screening eligibility uptake and adherence in puerto rico 2022 |
| topic | Lung cancer screening Puerto Rico Cancer disparities Hispanic or Latino health |
| url | http://www.sciencedirect.com/science/article/pii/S2666364325000694 |
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