Medical College of Wisconsin
CTSIResearch InformaticsREDCap

Geographic access to lung cancer screening and environmental lung cancer risk factors in the contiguous United States. Health Place 2026 Jan;97:103588

Date

11/29/2025

Pubmed ID

41313940

DOI

10.1016/j.healthplace.2025.103588

Scopus ID

2-s2.0-105028659320 (requires institutional sign-in at Scopus site)

Abstract

OBJECTIVE: Lung cancer is the leading cause of cancer mortality in the U.S., and worldwide. We examined the association between geographic access to lung cancer screening facilities (LCSF) and geographically distributed lung cancer risk factors - fine particulate matter (PM2.5) and indoor radon levels in the contiguous U.S.

METHODS: We estimated geographic access to LCSF using facility information from the American College of Radiology, Lung Cancer Screening Registry and the enhanced two-step floating catchment area method. Census tract level PM2.5 and county level radon data were obtained from the U.S. EPA. We examined whether PM2.5 and radon predicted geographic access to LCSF using a linear mixed effects model with random intercepts for counties, adjusting for smoking prevalence and other factors, and testing for modification by urban-rural area.

RESULTS: We found higher geographic access to LCSF in counties with moderate and high radon levels, and census tracts with higher levels of PM2.5, with significant modification by urban-rural areas.

DISCUSSION: Our results suggest that accessibility to LCSF in the U.S. is generally aligned with environmental risk factors for lung cancer, with the exception of micropolitan areas or small cities, where higher PM2.5 areas had lower screening access. It is worth considering how environmental risk factors may be incorporated into lung cancer screening programs.

Author List

Anyanwu C, Yang K, Bonne V, Kalkbrenner AE, Kostelac C, Beyer KMM

Authors

Kirsten M. Beyer PhD, MS, MPH Professor in the Institute for Health and Humanity department at Medical College of Wisconsin
Kai Yang PhD Assistant Professor in the Data Science Institute department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Air Pollution, Indoor
Early Detection of Cancer
Environmental Exposure
Female
Health Services Accessibility
Humans
Lung Neoplasms
Male
Particulate Matter
Radon
Risk Factors
United States