Less than one-in-five eligible patients in the U.S. are up to date with recommended lung cancer screening, according to a new study led by researchers at the American Cancer Society.
The study, published in JAMA highlighted that screening rates are significantly lower among uninsured patients, those without a usual source of care, and residents of Southern states, which bear the highest burden of lung cancer.
“Although lung cancer screening rates remain significantly low, this research indicates an improvement over previous years,” said Dr. Priti Bandi, Scientific Director of Cancer Risk Factors and Screening Surveillance Research at the American Cancer Society (ACS). “However, we still have a long way to go. We must push harder to move the needle in the right direction.”
The United States Preventive Services Task Force (USPSTF) and the ACS recommend annual screening with low dose computed tomography for early detection in eligible high-risk individuals. According to the USPSTF, high-risk individuals are those aged 50-80 years with a 20-pack-year or greater smoking history, who currently smoke or have quit within the past 15 years.
Researchers analyzed data from the 2022 Behavioral Risk Factor Surveillance System, a nationwide, state-representative survey. The study focused on self-reported up-to-date lung cancer screening (UTD-LCS), which was defined as past-year, and prevalence among respondents aged 50-79. Adjusted prevalence ratios (aPR) and 95% confidence intervals were used to compare differences.
Among the 25,958 eligible respondents, 61.5% reported currently smoking, 54.4% were male, 64.4% were aged 60 or older, 78.4% were White, and 53% had a high school education or less. Overall, UTD-LCS prevalence was 18.1%, but varied threefold across states (ranging from 31% to 9.7%), with notably lower levels in Southern states. UTD-LCS prevalence increased with age (6.7% for 50-54 years old vs. 27.1% for 70-79 years old) and the number of comorbidities (24.6% for those with three or more vs. 8.7% for those with none). Only 1 in 20 patients without insurance or a usual source of care were UTD with LCS. However, state-level Medicaid expansions (aPR: 2.68, 95% CI, 1.30, 5.53) and higher screening capacity levels (aPR: 1.93, 95% CI: 1.36, 2.75) were linked to higher UTD-LCS prevalence.
“Early detection with LCS is crucial because lung cancer symptoms often don’t appear in the early stages, but when diagnosed and treated early, survival rates improve significantly,” added Bandi. “National and state-based initiatives to expand healthcare access and screening facilities are essential to improving prevention, early detection, and treatment of lung cancer, ultimately saving lives.”
The American Cancer Society’s advocacy affiliate, the American Cancer Society Cancer Action Network (ACS CAN), is actively working at all government levels to advocate for lung cancer screening access.
“This research underscores the urgent need to eliminate all barriers to care access, ensuring people can utilize preventive and early detection screenings at no cost,” said Lisa Lacasse, president of ACS CAN. “Expanding Medicaid in the ten states that have not yet done so would greatly improve access to these lifesaving screenings and reduce lung cancer deaths. Eliminating patient costs for screening and follow-up tests by all payers would bring us closer to ending cancer as we know it, for everyone.”
Other ACS researchers contributing to the study include Jessica Star, Tyler Kratzer, and Dr. Robert Smith. Dr. Ahmedin Jemal is the senior author of the research.
For more information on lung cancer screening, read here.
For information on tobacco cessation, read here.