Barriers and Facilitators to Lung Cancer Screening in Rural and Academic Medical Center Primary Care Facilities

Abstract: Background. Rates of lung cancer mortality, incidence, and stage at diagnosis are poor. Objective. Explore staff and primary care providers' (PCP) barriers and facilitators in a rural versus academic medical center primary care to help explain low lung cancer screening (LCS) rates in primary care. Design. In May 2024, researchers conducted nine semi-structured interviews with six clinicians and staff of six rural primary care practices, and contrast interviews with three PCPs at the only quaternary academic medical center in the region. Setting. Interviews were conducted and recorded via Zoom, transcribed with Microsoft Word, and analyzed in Dedoose. Results. All participants reported positive views of LCS. Barriers included patient identification and workflow processes. Rural participants further reported lack of navigation, staffing, billing, and geographical distance. Conclusion. Patient identification contributes to lower rates of LCS in primary care. Addressing barriers could contribute to increased LCS, which could reduce mortality from lung cancer.