More than 80% of high-risk U.S. adults have never heard of lung cancer or have never discussed it with their health care practitioners, despite current guidelines recommending screening for 13 million eligible individuals.
In a new study, published in JAMA Network Open, investigators analyzed data from the 2022 Health Information National Trends Survey (HINTS-6) involving adults aged 50 to 80 years who formerly or currently smoked and have at least one primary care visit in the previous year. The survey achieved a 28.2% response rate.
Among 929 former smokers (representing an estimated 29 million), 18.1% had never heard of lung cancer screening (LCS), while 75.1% never discussed LCS with their clinicians. For 350 current smokers (representing 11.9 million), 13.5% were unaware of LCS and 71.1% did not discuss it with their health care provider.
There were significant variations across demographic groups. Among Hispanic participants who formerly smoked, 29.8% had never heard of LCS and 63.2% did not discuss it with clinicians. Among non-Hispanic Black participants, these figures were 12.4% and 83.2%, respectively, while non-Hispanic White participants reported 17.2% and 75.5%.
Education level data showed that among those with a high school education or less, 23.3% of former smokers had never heard of the test and 71.4% did not discuss it with their clinicians. Among those with college degrees or higher, these percentages were 15.8% and 76.8%, respectively.
Geographic analysis revealed that 92.7% of urban residents and 96.3% of rural residents who formerly smoked either never heard of or did not discuss LCS.
Clinical characteristics also showed disparities. Among those with existing lung conditions, 83.7% of former smokers and 83.9% of current smokers either never heard of or did not discuss LCS. Among individuals with a cancer history, 89% of former smokers and 74.9% of current smokers reported no screening discussions.
The American Lung Association has reported that only 4.5% of LCS-eligible individuals were up to date with screening in 2022.
Study limitations include its cross-sectional nature and lack of data on pack-years and years since quitting smoking.
Conflict of interest disclosures can be found in the study.
