In 2016, the Society of Behavioral Medicine highlighted that disparities endemic to lung cancer will remain and may be exacerbated by gaps in implementation of high-quality screening among high-risk populations. This is because a disproportionate burden of lung cancer incidence and mortality largely tracks disparities associated with higher tobacco use among individuals with fewer socioeconomic resources; some racial/ethnic minority groups; individuals residing in rural areas; the lesbian, gay, bisexual, transgender, and questioning community; and individuals with psychiatric comorbidity. They emphasized the importance of targeting efforts to reach underserved populations and provided a specific recommendation to expand the resource capacity for lung cancer screening within Federally Qualified Health Centers (FQHCs). FQHCs are safety-net clinics, often located in rural areas, whose underserved populations have a high burden of tobacco use. FQHCs comprise about 90% of the Community Health Centers program, which cared for more than 24 million low-income patients in the U.S. in 2015. Although FQHCs are mandated to provide preventive services, they may face substantial challenges to implementing lung cancer screening, given their unique patient population of underinsured and uninsured individuals. Recognizing the need for guidance about implementing screening in high-risk, underserved populations, this study surveyed a national sample of FQHC medical directors to explore potential barriers that impact screening access, uptake, and adherence in FQHC populations.
Citation: Zeliadt, S.B., Hoffman, R.M., Birkby, G., Eberth, J.M., Brenner, A.T., Reuland, D.S., & Flocke, S.A. (2018). Challenges implementing lung cancer screening in federally qualified health centers. American Journal of Preventive Medicine, 1-8. https://doi.org/10.1016/j.amepre.2018.01.001