{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T13:01:20Z","timestamp":1789995680985,"version":"4.0.1"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":81,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100001368","name":"V Foundation for Cancer Research","doi-asserted-by":"publisher","award":["D2023\u2010005"],"award-info":[{"award-number":["D2023\u2010005"]}],"id":[{"id":"10.13039\/100001368","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Given persistently low rates of lung cancer screening among eligible individuals, we examined racial and geographic differences in proximity to low\u2010dose computed tomography (LDCT) screening facilities among American Indians and Alaska Natives (AIAN) and White adults in North Carolina.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used cancer registry data linked with health insurance claims (2016\u20132020) to examine a cohort of 18,154 AIAN and NHW lung cancer patients. We calculated straight\u2010line distances between patient's residential ZIP code and nearest LDCT facility available in the year prior to diagnosis, (within ZIP code, 1\u201310 miles, or \u226510 miles). Logistic regression models assessed associations between distance and stage at diagnosis (localized vs. non\u2010localized and distant vs. non\u2010distant), adjusting for race, age at diagnosis, and health insurance status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>AIAN were more likely than NHW patients to live \u226510 miles from an LDCT facility (36%\u00a0vs. 17%) and less often diagnosed at a localized stage (19%\u00a0vs. 26%). Patients living \u2265\u00a010 miles away had lower odds of localized stage diagnosis (adjusted OR = 0.89; 95% CI: 0.82\u20130.98) compared to those with access within their residential ZIP code.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Greater distance to LDCT facilities was associated with reduced odds of early\u2010stage diagnosis. Strategies such as mobile screening units and culturally tailored outreach may improve access and outcomes in underserved AIAN communities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jrh.70207","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:41:20Z","timestamp":1787316080000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lung Cancer Screening Access and Cancer Stage at Diagnosis Among American Indian and White Patients"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0950-2907","authenticated-orcid":false,"given":"Bradford E.","family":"Jackson","sequence":"first","affiliation":[{"name":"Lineberger Comprehensive Cancer Center (LCCC) University of North Carolina at Chapel Hill (UNC\u2010CH)  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madison","family":"Uhrin","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill (UNC\u2010CH)  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie B.","family":"Wheeler","sequence":"additional","affiliation":[{"name":"Lineberger Comprehensive Cancer Center (LCCC) University of North Carolina at Chapel Hill (UNC\u2010CH)  Chapel Hill North Carolina USA"},{"name":"Department of Health Policy and Management Gillings School of Global Public Health University of North Carolina At Chapel Hill (UNC\u2010CH)  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher D.","family":"Baggett","sequence":"additional","affiliation":[{"name":"Lineberger Comprehensive Cancer Center (LCCC) University of North Carolina at Chapel Hill (UNC\u2010CH)  Chapel Hill North Carolina USA"},{"name":"Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill (UNC\u2010CH)  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa P.","family":"Spees","sequence":"additional","affiliation":[{"name":"Lineberger Comprehensive Cancer Center (LCCC) University of North Carolina at Chapel Hill (UNC\u2010CH)  Chapel Hill North Carolina USA"},{"name":"Division of Pharmaceutical Outcomes and Policy Eshelman School of Pharmacy University of North Carolina at Chapel Hill (UNC\u2010CH)  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel A.","family":"Begay","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill (UNC\u2010CH)  Chapel Hill North Carolina 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