New Study Finds Most Eligible U.S. Adults not Getting Screened for Lung Cancer

A new study led by American Cancer Society (ACS) researchers shows less than one-in-five eligible individuals in the United States were up-to-date (UTD) with recommended lung cancer screening (LCS). The screening uptake was much lower in persons without health insurance or usual source of care and in Southern states with the highest lung cancer burden. The findings are published today in JAMA (Journal of the American Medical Association) Internal Medicine.

“Although lung cancer screening rates continue to be considerably low, this research does show an improvement over screening rates reported for previous years,” said Dr. Priti Bandi, scientific director, cancer risk factors and screening surveillance research at the American Cancer Society. “But we clearly, 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 LCS with low-dose computed tomography in eligible high-risk individuals for early detection of the disease. High risk individuals according to the USPSTF are 50-80 years old, with a 20 pack-year or greater smoking history and currently smoking or quit less than 15 years ago.

For the study, researchers analyzed data from the 2022 Behavioral Risk Factor Surveillance System, a cross-sectional, population-based, nationwide state-representative survey. Self-reported UTD-LCS (defined as past-year) prevalence according to the 2021 USPSTF eligibility criteria was studied in respondents 50-79 years of age. Adjusted prevalence ratios (aPR) and 95% confidence intervals compared differences.

Study results showed among 25,958 sample respondents eligible for LCS, 61.5% reported currently smoking, 54.4% were male, 64.4% were ages 60 years of age or older, 78.4% were White persons, and 53% had a high-school education or less. UTD-LCS prevalence was 18.1% overall, but varied 3-fold across states (range, 31% to 9.7%) with relatively lower levels in Southern states characterized by a high lung cancer mortality burden. UTD-LCS prevalence increased with age (50-54 years old: 6.7% vs. 70-79 years old: 27.1%) and number of comorbidities (≥3: 24.6% vs. none: 8.7%). Just 1 in 20 persons without insurance or a usual source of care were UTD with LCS, but state-level Medicaid expansions (aPR: 2.68, 95% CI, 1.30, 5.53) and higher screening capacity levels (high vs. low, aPR: 1.93, 95% CI: 1.36, 2.75) were associated with a higher UTD-LCS prevalence.

“Early detection with LCS is critical because lung cancer symptoms often don’t appear in the early stages, but when diagnosed and treated early, survival is markedly improved,” added Bandi. “National and state-based initiatives to expand access to healthcare and screening facilities are needed to continue to improve, prevention, early detection and treatment for lung cancer to help save lives.”

The American Cancer Society’s advocacy affiliate, the American Cancer Society Cancer Action Network (ACS CAN), continues to work at all levels of government to advocate for access to lung cancer screenings.

“This research further amplifies the critical need for reducing all barriers to access to care to ensure people are able to immediately utilize preventive and early detection screenings at no cost,” said Lisa Lacasse, president of the ACS CAN. “Expanding Medicaid in the 10 states that have yet to do so would significantly improve access to these lifesaving screenings and decrease lung cancer deaths, as well as eliminating patient costs for screening and follow-up tests by all payers, bringing 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 senior author of the research.

For more information on lung cancer screening, read here.

For information on tobacco cessation, read here.

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About the American Cancer Society The American Cancer Society is a leading cancer-fighting organization with a vision to end cancer as we know it, for everyone. For more than 110 years, we have been improving the lives of people with cancer and their families as the only organization combating cancer through advocacy, research, and patient support. We are committed to ensuring everyone has an opportunity to prevent, detect, treat, and survive cancer. To learn more, visit cancer.org or call our 24/7 helpline at 1-800-227-2345. Connect with us on Facebook, X, and Instagram.