Date of Award

Spring 5-13-2026

Degree Type

Campus Access Capstone

Degree Name

Master of Science in Nursing (MSN)

Department

Nursing

First Advisor

Jessica Bardina, DNP, AGNP-C

Keywords

lung cancer screening, low-dose computed tomography, East Asian adults, Greater Boston, health disparities, risk-based screening

Subject Categories

Family Practice Nursing | Nursing | Oncology | Preventive Medicine | Primary Care | Public Health and Community Nursing | Pulmonology

Abstract

This capstone examines lung cancer screening disparities among East Asian adults in Greater Boston, focusing on the mismatch between current smoking-based screening criteria and population-specific risk patterns. A PRISMA-informed review and integrated analysis were used to synthesize prior population health, evidence-based intervention, policy, and stakeholder work related to risk-based low-dose computed tomography (LDCT) screening. Findings indicate that many East Asian adults who develop lung cancer may not be identified through screening criteria based primarily on smoking history, particularly because lung cancer in this population frequently occurs among individuals who have never smoked. The review also identified barriers related to language access, insurance coverage, clinical workflow, cancer stigma, and limited culturally responsive outreach. The proposed evidence-based intervention is an electronic health record-integrated, primary care-based risk assessment and referral protocol that incorporates ancestry, family history, environmental exposures, and other clinical risk factors into LDCT screening decisions. Implementation would require clinician education, radiology coordination, payer engagement, bilingual patient navigation, and partnerships with trusted community organizations. A risk-based LDCT screening approach offers a feasible strategy to improve early detection, reduce delayed diagnosis, and promote more equitable lung cancer screening access for East Asian adults in Greater Boston.

Comments

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