Rural barriers to early lung cancer detection: Exploring access to lung cancer screening programs in New Hampshire and Vermont

Rural populations face many health disadvantages compared to urban areas. There is a critical need to better understand the current lung cancer screening landscape in these communities to identify targeted areas to improve the impact of this proven tool. Data from the County Health Rankings of New Hampshire and Vermont was reviewed for population density, distribution of adult smokers, and level of education compared to the distribution of Lung Cancer Screening Facilities throughout these two states. Screening programs in southern counties of Vermont with lower levels of education have decreased access. In New Hampshire, there are no programs within 30 miles of the areas with the largest distribution of smokers, and decreased access in some areas with the lowest levels of education. Improving equitable access to high-quality screening services in rural regions and the creation of targeted interventions to address decreased access in areas of high tobacco use and low education is vital to decreasing the incidence of latestage presentations of lung cancer within these populations. •The zip code is wrong. The address for Dartmouth-Hitchcock should be 1 Medical Center Drive, Lebanon, NH 03756.•The Dartmouth institute should be The Dartmouth Institute for Health Policy and Clinical Practice.•There are few accredited lung cancer screening facilities in areas with high smoking rates and low educational attainment.•Targeted interventions to address this decreased access is key to decreasing late-stage presentations of lung cancer.•Equitable access to high-quality screening services in rural areas is vital to ensuring successful early detection efforts.