title: Lung cancer screening using low-dose CT: the current national landscape.
abstract: OBJECTIVE
  Although the National Lung Screening Trial (NLST) lauds the efficacy of low-dose computed tomography (LDCT) at reducing lung cancer mortality, it has not been widely used for population-based screening. By examining the availability of U.S. LDCT screening centers, and underlying rates of lung cancer incidence, mortality, and smoking prevalence, the need for additional centers may be determined.
  
  
  METHODS
  Locations of 203 LDCT screening centers from the Lung Cancer Alliance Screening Centers of Excellence database, a list of active NLST and International Early Lung and Cardiac Action Program (I-ELCAP) screening centers, and an independently conducted survey of Society of Thoracic Radiology members were geocoded and mapped. County-level rates of lung cancer incidence, mortality, and smoking prevalence were also mapped and overlaid with the locations of the 203 LDCT screening centers.
  
  
  CONCLUSIONS
  Results showed the majority of LDCT screening centers were located in the counties with the highest quartiles of lung cancer incidence and mortality in the Northeast and East North Central states, but several high-risk states had no or few identified screening centers including Oklahoma, Nevada, Mississippi, and Arkansas. As guidelines are implemented and reimbursement for LDCT screening follows, equitable access to LDCT screening centers will become increasingly important, particularly in regions with high rates of lung cancer incidence and smoking prevalence.
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, United States; Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, United States. Electronic address: jmeberth@mailbox.sc.edu.
authors.forename: Jan M
authors.initials: JM
authors.lastname: Eberth
authors.affiliation: Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, United States. Electronic address: qiur@sc.edu.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Qiu
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, United States; Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, United States; School of Nursing, University of South Carolina, United States. Electronic address: Swann.adams@sc.edu.
authors.forename: Swann A
authors.initials: SA
authors.lastname: Adams
authors.affiliation: Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, United States. Electronic address: rsalloum@sc.edu.
authors.forename: Ramzi G
authors.initials: RG
authors.lastname: Salloum
authors.affiliation: School of Nursing, University of South Carolina, United States. Electronic address: nateb@mailbox.sc.edu.
authors.forename: Nathanial
authors.initials: N
authors.lastname: Bell
authors.affiliation: Department of Surgery, School of Medicine, University of South Carolina, United States. Electronic address: Amanda.arrington@uscmed.sc.edu.
authors.forename: Amanda K
authors.initials: AK
authors.lastname: Arrington
authors.affiliation: Sealy Center on Aging, The University of Texas Medical Branch-Galveston, United States. Electronic address: suliner@utmb.edu.
authors.forename: Suzanne K
authors.initials: SK
authors.lastname: Linder
authors.affiliation: Department of Radiology, Houston Methodist, United States. Electronic address: rfmunden@houstonmethodist.org.
authors.forename: Reginald F
authors.initials: RF
authors.lastname: Munden
mesh_terms: D055088:Early Detection of Cancer; D005843:Geography; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D008403:Mass Screening; D011156:Population Density; D015995:Prevalence; D011829:Radiation Dosage; D012907:Smoking; D014057:Tomography, X-Ray Computed; D014481:United States / Q000453:epidemiology
keywords: Early detection of cancer; Geographic information systems; Geographic mapping; Health services accessibility; Lung neoplasms; Smoking; Spiral computed tomography