Geospatial Analysis of Accredited Lung Cancer Screening Facilities in Florida Reveals Suboptimal Alignment with High-Risk Populations.

Low-dose computed tomography (LDCT) plays a critical role in screening individuals for lung cancer. To better understand why its utilization remains poor, we analyzed the geospatial distribution of lung cancer screening programs in Florida to determine whether the distribution of these programs aligns with populations at greatest risk. Accredited programs offering LDCT were identified from public databases maintained by the American College of Radiology (ACR). Age-adjusted incidence and mortality for lung cancer were retrieved from the Florida Cancer Data System and Florida Department of Health. County-level demographic features were retrieved from the 2022 U.S. Census and Florida Department of Health. Univariate Pearson correlations and Kruskal-Wallis analyses revealed that screening programs in Florida are more likely to be located in counties with greater population density and a greater proportion of college-educated residents, physicians per capita, and residents with private insurance. In contrast, the number of facilities correlated inversely with the proportion of current smokers, White residents, and lung cancer incidence and mortality. In multivariate analyses, only smoking remained significantly associated with disease-specific incidence or mortality. No association between outcomes and the number of facilities in each county was identified. In conclusion, these findings indicate that the geographic distribution of certified screening programs in Florida does not align with lung cancer burden. Moving forward, strategies to address this mismatch may be helpful for improving the early detection of lung cancer. SIGNIFICANCE: Our findings indicate that there is a significant misalignment between the distribution of ACR-accredited facilities offering LDCT for screening and the regions of Florida where the incidence and mortality of lung cancer are greatest. In contrast to previous reports examining national data, our data suggest that these geographic disparities limit the ability of populations most vulnerable to lung cancer to ACR-certified screening.