942. Lung Cancer Screening in at-risk patients with HIV in a Midwestern Clinic

BACKGROUND: Patients with HIV (PWH) have an increased risk of lung cancer compared to the general population. In 2013, the U.S. Preventive Services Task Force (USPSTF) released their lung cancer screening (LCS) guidelines for the general population. The objective of this study is to evaluate the frequency of and factors associated with LCS using computed tomography in at-risk PWH. METHODS: A retrospective chart review of patients 55-80 years old seen at a Midwestern HIV Clinic between July 1, 2016 to June 30, 2018 was conducted. Demographic, clinical, laboratory, and referral for LCS information were collected. Descriptive statistics and logistic regression models were used for analysis. RESULTS: We reviewed 347 patients, out of whom 91 were excluded for the following reasons: never smoked (8), deceased (38), pack history unknown (39), and prior lung cancer diagnosis (6). Mean (sd, range) for age was 61 (5.0, 55-78). A total of 256 patients were included in the analysis, out of whom 104 (41%) met the USPSTF criteria. No effect was identified for demographic information including race, ethnicity, gender, or insurance status on LCS referral. LCS referral was made for 22 out of 256 patients (9%) (13% of patients who met the USPSTF criteria and 5% of those who did not). Patients who received tobacco cessation counseling (OR 7.83, P=0.047) and with hepatitis C infection (OR 4.32, P=0.002) were more likely to receive LCS referral. Out of those who received LCS referral, 12/22 (55%) completed the referral. Patients with hepatitis C infection were more likely to complete LCS referral (OR 8, P=0.038). CONCLUSION: Only 13% of patients who met USPSTF criteria were referred for LCS. Patients who received tobacco cessation counseling were more likely to receive a referral. Patients with hepatitis C infection were more likely to receive and complete LCS referral. Quality improvement efforts to improve rates of LCS in PWH are needed. Future prospective studies should examine the factors associated with LCS in PWH. DISCLOSURES: Sara H. Bares, MD, Gilead Sciences (Grant/Research Support)