Abstract C151: Factors associated with patient refusals for lung cancer screening referrals at a New York city-based cancer center: A qualitative exploration

Abstract Lung cancer is the leading cause of cancer death in the United States (US) and globally. Timely lung cancer screening can reduce lung cancer mortality but is still underutilized. NYU Langone’s Laura and Isaac Perlmutter Cancer Center (PCC) is a National Cancer Institute (NCI)-designated Comprehensive Cancer Center and has been part of the NCI Early Detection Research Network since 2000. PCC is home to the NYU Langone Lung Cancer Screening Program, which offers lung cancer screening for patients at risk for developing lung cancer. This study qualitatively explores and understands factors associated with patients who refuse lung cancer screening referrals at the NYU Langone Lung Cancer Screening Program at PCC. Semi-structured individual interviews were conducted among referred patients (n=7) and referring providers (n=4) for lung cancer screening to assess experiences, barriers, and facilitators. Two focus groups were also conducted with the Lung Cancer Screening Program staff (n=3) at two time points to understand processes and workflows. Interviews and focus groups were audio-recorded and transcribed verbatim. Findings were identified through thematic content analysis. Preliminary findings include the following major multi-level themes: 1) Clear communication and adequate information—e.g., clearer explanations from providers, explanations in simple terms and in patients’ preferred languages; 2) Trust in providers—e.g., patient trust in provider’s recommendations; 3) Barriers to screening—e.g., cost, insurance, and accessibility of the lung cancer screening appointment; 4) Need for proactive outreach and tailored patient engagement—e.g., text messages or direct calls rather than flyers, shared decision-making is key but considerations include different cultural groups having different preferences for receiving health information; and 5) Importance of system-level improvements to streamline screening—e.g., screenings integrated within regular healthcare system, better coordination between patient’s care team. Findings indicate opportunities to improve lung cancer screening uptake through a patient-centered approach that improves education, trust, accessibility, and system coordination. Citation Format: Deborah Min, Yousra Yusuf, Victoria Foster, K. Alisa Braithwaite, Patrice Cherry-Georges, Melissa Morgan, Megan Haseltine, Jorge Mercado, Abraham Chachoua, Daniel H. Sterman, Simona C. Kwon, Matthew Lee. Factors associated with patient refusals for lung cancer screening referrals at a New York city-based cancer center: A qualitative exploration [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C151.