Most High-Risk Adults Not Getting Screened for Lung Cancer, New Study Finds

ATLANTA, June 10, 2024—A new study led by American Cancer Society researchers shows less than one in five eligible individuals in the United States were up to date 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 were published in JAMA 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 for 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 American Cancer Society 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 to 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, up-to-date LCS (defined as past-year) prevalence according to the 2021 USPSTF eligibility criteria was studied in respondents who were 50 to 79 years of age. Adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) compared differences.

Study results showed among 25,958 sample respondents eligible for LCS, 61.5 percent reported currently smoking, 54.4 percent were male, 64.4 percent were ages 60 years of age or older, 78.4 percent were White persons, and 53 percent had a high school education or less. Up-to-date LCS prevalence was 18.1% percent overall but varied three-fold across states (range of 9.7 percent to 31 percent) with relatively lower levels in Southern states characterized by a high lung cancer mortality burden. 

Up-to-date LCS prevalence increased with age (50 to 54 years old: 6.7 percent versus 70 to 79 years old: 27.1 percent) and number of comorbidities (at least three: 24.6 percent versus none: 8.7 percent). Just one in 20 persons without insurance or a usual source of care were up to date with LCS, but state-level Medicaid expansions (aPR: 2.68, 95 percent CI, 1.30, 5.53) and higher screening capacity levels (high versus low, aPR: 1.93, 95 percent CI: 1.36, 2.75) were associated with a higher up-to-date 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 health care 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.”

- This press release was originally published on the American Cancer Society’s website.