BC Cancer, Provincial Health Services Authority, Vancouver, BC V5Z 4C2, Canada.
BC Cancer Screening, BC Cancer, Provincial Health Services Authority, Vancouver, BC V5Z 1G1, Canada.
Curr Oncol. 2023 Aug 31;30(9):8078-8091. doi: 10.3390/curroncol30090586.
The successful implementation of an equitable lung cancer screening program requires consideration of factors that influence accessibility to screening services.
Using lung cancer cases in British Columbia (BC), Canada, as a proxy for a screen-eligible population, spatial access to 36 screening sites was examined using geospatial mapping and vehicle travel time from residential postal code at diagnosis to the nearest site. The impact of urbanization and Statistics Canada's Canadian Index of Multiple Deprivation were examined.
Median travel time to the nearest screening site was 11.7 min (interquartile range 6.2-23.2 min). Urbanization was significantly associated with shorter drive time ( < 0.001). Ninety-nine percent of patients with ≥60 min drive times lived in rural areas. Drive times were associated with sex, ethnocultural composition, situational vulnerability, economic dependency, and residential instability. For example, the percentage of cases with drive times ≥60 min among the least deprived situational vulnerability group was 4.7% versus 44.4% in the most deprived group.
Populations at risk in rural and remote regions may face more challenges accessing screening services due to increased travel times. Drive times increased with increasing sociodemographic and economic deprivations highlighting groups that may require support to ensure equitable access to lung cancer screening.
公平的肺癌筛查计划的成功实施需要考虑影响筛查服务可及性的因素。
以加拿大不列颠哥伦比亚省（BC）的肺癌病例作为筛查合格人群的替代指标，使用地理空间映射和从诊断时的住宅邮政编码到最近筛查点的车辆行驶时间，检查了 36 个筛查点的空间可达性。研究了城市化和加拿大统计局的加拿大多重剥夺指数的影响。
到最近筛查点的平均旅行时间为 11.7 分钟（四分位间距 6.2-23.2 分钟）。城市化与较短的驾驶时间显著相关（<0.001）。≥60 分钟车程的患者中 99%居住在农村地区。行驶时间与性别、民族文化构成、处境脆弱性、经济依赖性和居住不稳定性有关。例如，在处境最脆弱的人群中，行驶时间≥60 分钟的病例比例为 4.7%，而在处境最脆弱的人群中，这一比例为 44.4%。
由于旅行时间增加，农村和偏远地区的高危人群可能在获得筛查服务方面面临更多挑战。随着社会经济剥夺程度的增加，行驶时间增加，突出了需要支持以确保公平获得肺癌筛查的群体。
