To the Editor. Lung cancer is the leading cause of cancer death in the United States in part because only 15% of lung cancers are diagnosed at a curable stage (1). Screening with low-dose computed tomography (LDCT) has been shown to reduce lung cancer mortality by up to 20% (2), and the United States Preventive Services Task Force recommends annual screening with LDCT for high-risk adults aged 55-80 years with a 30-pack-year smoking history and who currently smoke or have quit within the previous 15 years. Despite this recommendation, uptake of screening has been poor, and in 2015, less than 4% of those eligible were screened (3). The United States Preventive Services Task Force recommends screening be conducted in facilities with licensed staff with experience in interpreting LDCT scans and a team of specialists who can provide appropriate follow-up. Although underuse of lung cancer screening may be due to a number of potential barriers, here we specifically investigate spatial access to lung cancer screening centers.
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