Summary: A new American Cancer Society study shows that less than one-in-five eligible individuals in the U.S. are up-to-date with recommended lung cancer screening, with particularly low rates among the uninsured, those lacking usual care, and in Southern states, highlighting the need for improved access to screening and healthcare.

Key Takeaways:

  1. Low Screening Rates: Less than 20% of eligible individuals in the U.S. are up-to-date with recommended lung cancer screening, with particularly low rates among the uninsured and those without a usual source of care.
  2. Regional Disparities: Screening rates are significantly lower in Southern states, which have the highest lung cancer burden.
  3. Improvement Over Time: Despite the low overall rates, the study indicates an improvement in lung cancer screening rates compared to previous years.
  4. Annual Low-Dose CT Recommended: The USPSTF and ACS recommend annual low-dose CT scans for high-risk individuals to detect lung cancer early.

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A new study by American Cancer Society (ACS) researchers shows that less than one-in-five eligible individuals in the U.S. are up-to-date (UTD) with recommended lung cancer screening. Screening rates are particularly low among those without health insurance, those lacking a usual source of care, and in Southern states with the highest lung cancer burden.

Low-Dose CT Recommendation

“Although lung cancer screening rates continue to be considerably low, this research does show an improvement over screening rates reported for previous years,” says Priti Bandi, PhD, scientific director, cancer risk factors and screening surveillance research at the ACS. “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 CT 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.

Lung Cancer Screening Rates

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.

Among 25,958 eligible respondents, 61.5% currently smoked, 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, 18.1% were UTD with lung cancer screening (LCS), but this varied threefold across states, with Southern states having lower rates. UTD-LCS prevalence increased with age (6.7% for 50-54 years old vs. 27.1% for 70-79 years old) and number of comorbidities (24.6% for ≥3 vs. 8.7% for none). Only one in 20 without insurance or usual care were UTD, but state Medicaid expansions and higher screening capacity were linked to higher UTD-LCS rates.

“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,” adds 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 Push for Better Lung Cancer Screening Access

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,” says 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.”