Negative social determinants of health are linked to lung cancer screening underutilization
Author Department
Medicine; Healthcare Quality
Document Type
Article, Peer-reviewed
Publication Date
12-2025
Abstract
Introduction: This study aimed to examine the association between social determinants of health (SDOH) and lung cancer screening (LCS) utilization.
Methods: We analyzed data from 15,957 LCS-eligible individuals in the 2022 Behavioral Risk Factor Surveillance System survey. Primary outcomes included ever having (lifetime) LCS and meeting LCS recommendations (i.e., annual LCS). Multivariable logistic regression models examined associations between LCS outcomes and 12 adverse SDOH factors, controlling for covariates (i.e., demographics, diagnosis of asthma/COPD, and perceived general health status).
Results: LCS-eligible individuals with more adverse SDOH had lower odds of ever having LCS and being up to date. Those with ≥5 adverse SDOH had the lowest odds of having lifetime LCS (AOR = 0.58, 95%CI: 0.45-0.74) and meeting LCS recommendations (AOR = 0.49, 95%CI: 0.36-0.65) compared to those with none. Life dissatisfaction, lack of social and emotional support, housing insecurity, lack of health insurance, and cost as a barrier for needed medical care were independently associated with lower LCS uptake.
Conclusions: Having more adverse SDOH was associated with a lower likelihood of having lifetime LCS and meeting the recommendation, with life dissatisfaction, lack of social and emotional support, housing insecurity, lack of health insurance, and medical care cost being independently associated factors.
Keywords: Lung cancer; SDOH; lung cancer screening; smoking; social determinants of health.
Plain language summary
Lung cancer screening (LCS) remains low among eligible populations.People with more adverse social determinants of health (SDOH) had lower odds of having a lifetime LCS.People with more adverse SDOH are also less likely to meet LCS recommendations.Lack of social and emotional support, housing insecurity, and lack of health insurance were associated with lower odds of having a lifetime LCS.Life dissatisfaction, lack of social and emotional support, lack of health insurance, and cost as a medical care barrier were associated with lower odds of meeting the LCS recommendation.
Recommended Citation
Do VV, Núñez ER, Wilder FG, Nguyen N. Negative social determinants of health are linked to lung cancer screening underutilization. Lung Cancer Manag. 2025 Dec;14(1):2583639. doi: 10.1080/17581966.2025.2583639. Epub 2025 Nov 5.
PMID
41191647