Abstract 2242: Impact of low-dose computed tomography screening for lung cancer at a community oncology clinic on stage of lung cancer diagnosis in the catchment area

Introduction: Arkansas has the second-highest incidence of lung cancer in the U.S., with a largely rural and medically underserved population. Low-dose computed tomography (LDCT) is a well-established procedure for lung cancer screening in academic medical centers, but few local community oncology centers utilize this technology. Highlands Oncology Group (HOG), located in Northwest Arkansas (NWA), took the initiative to bring LDCT screening to a non-academic medical center and provide routine LDCT screening to a rural population. The objective of this study is to evaluate the benefits of free LDCT screening at a community oncology clinic. Methods: The study compared for-fee and free periods of LDCT screening at HOG and their impact on identifying cancer in NWA. The study population was patients in HOG’s catchment area who fell into the risk categories set by the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology to be eligible for screening between March 2013 and February 2020. Results: A total of 5,402 eligible participants enrolled in the study. During ten months of for-fee screening (n=60), 3.3% of patients diagnosed had Stage I lung cancer, and 1.7% were diagnosed with Stages II-IV. During the first ten months of free screening (n=729), 3% of patients were diagnosed with Stage I lung cancer, 1.8% were diagnosed with Stages II-IV, and 1.1% were diagnosed with other cancers. Over the entire program until February 2020 (n=5,402), a total of 76 patients were diagnosed with Stage I lung cancer, 52 were diagnosed with Stage II-IV, and 35 were diagnosed with other cancers. Conclusion: The result of this study suggests that eligible patients are more receptive to free lung cancer screening, even though most insurance coverage does not have a required co-pay for eligible patients. We also observed an increased diagnosis rate for early-stage lung cancers due to increased patient influx with free LDCT screening. The state central registry data showed a decline in distant lung cancer after the free LDCT screening offered in the northwestern counties in the HOG catchment area. At the same time, no such trend is visible for the entire state, suggesting a stage shift in lung cancer due to free LDCT screening. Citation Format: Edgar T. Ellis, Michael A. Bauer, Thaddeus Beck, Daniel S. Bradford, Joanna Thompson, Margarete C. Kulik, Joseph L. Su. Impact of low-dose computed tomography screening for lung cancer at a community oncology clinic o