Travel distance to nearest lung cancer facility differs by racial and ethnic makeup of communities

Embargoed for release until 5:00 p.m. ET on Monday 13 January 2025   

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Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.         
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1. Travel distance to nearest lung cancer facility differs by racial and ethnic makeup of communities

American Indian/Alaska Native populations are 5 times further away from lung cancer screening centers than non-Hispanic White populations.

Abstract: https://www.acpjournals.org/doi/10.7326/M24-0124  

URL goes live when the embargo lifts          

A cross-sectional ecological study found that there are differences in travel distance to lung cancer screening (LCS) facilities by race and ethnicity, but those differences are only partially explained by rurality. According to the study authors, these findings could inform the placement of future imaging locations and mobile units for LCS to increase equitable access to LCS services. The results are published in Annals of Internal Medicine.

Researchers from Washington State University and Swedish Cancer Institute studied data from 71,691 U.S. census tracts (2,500-8,000 people) to examine race-, ethnicity-, and rurality-based differences in distance to the nearest LCS facility. The researchers focused on American Indian/Alaska Native (AI/AN) populations compared to non-Hispanic White (NHW) populations due to their high prevalence of smoking and status as the nation’s most rural-dwelling population. The outcome variable was road distance in miles from a census tract to the closest LCS facility. Independent variables measured were census tract racial and ethnic composition and rurality. The researchers defined a predominant racial/ethnic majority of a census tract as more than 50% of census tract residents identifying with one of the following racial or ethnic categories: AI/AN, Asian, Black, NHW, no single race, or Hispanic. No single race majority census tracts were defined as those in which none of the aforementioned racial populations comprised a majority of the population. Census tracts with Native Hawaiian/Pacific Islander majority were excluded due to small numbers. Census tract rurality was defined by rural-urban commuting area (RUCA) codes. The researchers found that AI/AN-majority census tracts had the longest geometric mean distance to the nearest LCS facility at 49.6 miles compared to 4.4 to 6.9 miles in other majority census tracts. For Asian-, Black-, and Hispanic-majority tracts, distance to the nearest LCS were 16%, 39% and 7% shorter, respectively, than those in NHW-majority tracts. When adjusted for rurality, the mean distance in AI/AN-majority tracts was reduced, but still more than three times the distance in NHW-majority census tracts. Adjustment for rurality also reduced the observed advantage in Asian- and Black-majority census tracts compared to NHW tracts, whereas Hispanic census tracts changed from being slightly closer to slightly further away from the nearest LCS facility. The researchers note that the observed differences in access to LCS facilities for AI/AN people are concerning given that lung cancer is the leading cause of cancer deaths among AI/AN people. 

Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To speak with corresponding author Solmaz Amiri, please email Stephanie Engle at stephanie.engle@wsu.edu. 

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2. Post discharge contact with patients does little to reduce care use or improve outcomes

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-24-01140  

URL goes live when the embargo lifts         

A systematic review of randomized and nonrandomized trials found that post discharge contacts (PDCs) 7 days after hospitalization did not reduce emergency department (ED) use or readmissions compared to usual care. According to the study authors, these findings suggest that health systems could reconsider the use of universal PDCs. The study is published in Annals of Internal Medicine. 

PDCs are widely used by health systems across the U.S., but there is little evidence of their effect on use of acute care and patient satisfaction after discharge. Researchers from the Department of Veterans Affairs studied data from 13 randomized and nonrandomized trials of the effectiveness of PDCs within 7 days after hospital discharge. Of the 13 included studies, the primary delivery method of PDCs was via telephone. Personnel involved in PDCs included pharmacists, nurses and nonclinical staff. Most PDC interventions consisted of a single telephone contact, but others included a patient-driven hotline, two direct telephone contacts and daily video conferencing for 5 to 9 days after discharge. No study evaluated multiple PDC delivery methods. The researchers found no evidence that PDCs within 7 days of discharge had an effect on 30-day ED use, 30-day hospitalizations or 30-day unplanned health care use. They also found that PDCs had no effect on patient satisfaction. The results suggest that health care systems should reevaluate their widespread use of common PDC approaches for these outcomes and consider targeted, multifaceted interventions to reduce use of acute care after discharge.

Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To speak with corresponding author Joel C. Boggan, MD, MPH, please email Sarah Avery at sarah.avery@duke.edu.

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Also new in this issue:

Metabolic dysfunction-associated steatotic liver disease (MASLD)

Sajjadh M.J. Ali, MD; Michelle Lai, MD, MPH

In the Clinic

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-24-02933

ACP Letter to Presidential Transition Team

Isaac O. Poole, MD, PhD on behalf of the American College of Physicians

URL: https://www.acpjournals.org/doi/10.7326/ANNALS-24-04125