Emergency Room, Cardiology, and Preoperative Clinics Represent the Most Visited Departments by Lung Cancer Screening-eligible Patients.

Abstract

Lung cancer screening (LCS) with low-dose computed tomography (LDCT) is an underused preventive tool. To target LCS resources, this study aimed to determine which departments LCS-eligible patients encountered most frequently in a large health system. The study investigators queried electronic medical records by age (≥50 years) and smoking status between January 1, 2021, and May 31, 2022, within a hospital system (INOVA Fairfax Medical Center, Fairfax, VA) (n = 62,630). They randomly reviewed every 20th chart (n = 3704) for LCS eligibility. Medical record numbers were used to track encounters with departments and service lines and to determine whether LDCT was done. The χ² test was used to test differences in department use by demographics and differences in LDCT uptake by department. Of the 3704 patients assessed, 460 LCS-eligible patients were identified. Of these 460 patients, the mean age was 64 (8) years, and 201 (44%) were female. The study population comprised 328 White (71%), 54 Black (12%), 25 Asian (5%), and 54 Hispanic (12%) patients. The most visited departments by the LCS-eligible patients were emergency (225, 49%), cardiology (202, 44%), the preoperative service line (179, 39%), and orthopedics (63, 14%). There was no difference in department use by sex, race, or ethnicity (P > .05). Overall LCS uptake was 17.2% (79 of 460), and there was no significant difference by visited departments. The emergency department, cardiology department, and preoperative clinics were the most common locations for encounters by LCS-eligible patients. This study helps identify clinics where the study investigators will plan to focus interventions to improve LCS uptake.