Perceived Racial Discrimination in Health Care Settings and Lung Cancer Screening Use.

BACKGROUND

Racial and ethnic minoritized individuals have lower uptake of lung cancer screening (LCS). It is unclear how perceived racial discrimination in the health care setting affects LCS uptake.

OBJECTIVES

The purpose of this study was to investigate the association between perceived racial discrimination in health care and LCS use among LCS-eligible adults in the United States.

METHODS

We used population-based, cross-sectional data from the 2022 Behavioral Risk Factor Surveillance System Survey Reaction to Race module. Eligible participants were adults aged 50-79 who currently use cigarettes or quit within the past 15 years and have ≥20 pack-years of tobacco use history. The outcome was LCS use in the past year. The key predictor was self-reported racial discrimination experienced in a health care setting within the past 12 months. We conducted descriptive statistics, including frequencies, weighted means, and percentages and weighted multinomial multivariable logistic regression analysis.

RESULTS

The majority of study participants were men, aged 50-64 years, non-Hispanic White, metropolitan county residents, and held high school or less education. Individuals perceiving racial discrimination had lower odds of LCS uptake in the past year compared with those who did not report such experience. The odds of LCS utilization in the past year were higher among individuals with certain characteristics, such as men (vs. women), aged 65-79 (vs. 50-64 y), retired (vs. employed), and metropolitan area residents (vs. nonmetropolitan residents).

DISCUSSION: LCS utilization remains low, and perceived racial discrimination is associated with low uptake of LCS. Strategies such as digital LCS resources, diversifying the health care workforce, and cultural competence training for the providers may address perceived racial discrimination and ensure equitable LCS initiatives to improve LCS participation.