2021 LCRF Research Grant on Disparities in Lung Cancer
Loretta Erhunmwunsee, MD
City of Hope Comprehensive Cancer Center
Using social determinants of health to predict adherence of lung cancer screening in minority high-risk smokers
Lung cancer is the number one cancer killer worldwide. Lung cancer screening (LCS) through low dose CT (LDCT) allows early detection of lung cancer in high risk smokers. Guidelines recommend annual LDCTs in order for survival benefit to be achieved. Unfortunately, adherence (obtaining LDCTs annually) is as low as 40% in some marginalized communities. Because the burden of lung cancer is already disproportionately carried by racial and ethnic minority groups, it is important to understand what factors may prevent these communities from adhering to these guidelines. Clearly, without guideline adherence, the survival benefit from LCS will not be realized in underserved communities and non-small cell lung cancer (NSCLC) disparities may widen.
This study proposes to evaluate the individual and neighborhood level social determinants of health that impact LCS adherence in minority individuals and develop a predictive tool that uses state-of-the-art artificial intelligence/machine learning technologies to determine which individual will be at high-risk for non-adherence. We will recruit 300 minority smokers who underwent their first LDCT in 2018-2020 and collect information on whether they completed their follow up scan within 15 months later, their age, race, sex, income, education, perceived discrimination, smoking status, financial and food insecurity. We will also obtain neighborhood level socioeconomic data based on the participants’ addresses. We will then use all of this data to develop a prediction model to identify people unlikely to present for their recommended LDCT. The accuracy of the model will be evaluated in a second group of 180 minority individuals who underwent their LDCT in 2021. Completion of the current proposal will inform the development of a LCS navigation intervention for individuals identified as high-risk for non-adherence.
* * This project was awarded the LCRF William C. Rippe Award for Distinguished Research in Lung Cancer, acknowledging the investigator whose proposal not only demonstrated exceptional scientific merit but also exemplified an enduring commitment to making an impact in the field of lung cancer research.