Lung Cancer Screening Rates Remain Very Low

Veronica Hackethal, MD

February 02, 2017

The rates of lung cancer screening among current and former heavy smokers remain very low and have remained unchanged despite recommendations for annual screenings in this high-risk group, according to a study published online on February 2 in JAMA Oncology.

The authors estimate that among 6.8 million smokers eligible for low-dose computed tomography (LDCT) screening in 2015, only 262,700 received it.

"The reasons for the low uptake in screening are probably varied and likely include lack of knowledge among both smokers and doctors as to screening recommendations as well as access to high-quality screening," lead author Ahmedin Jemal, DVM, PhD, from the American cancer Society, said in a statement.

Lung cancer is the leading cause of cancer deaths in the United States, causing more than 155,000 deaths each year. Screening could prevent thousands of these deaths each year, according to background information in the article.

"Our previous study showed implementing quality screening broadly across the US could prevent about 12,000 lung cancer deaths every year in the short term. But we cannot prevent those deaths until and unless we start educating eligible smokers as well as clinicians about the benefits and risks of screening, so patients can make an informed decision," Dr Jemal commented.

In December 2013, the US Preventive Services Task Force (USPSTF) issued recommendations calling for annual screening with LDCT in people aged 55 to 80 years who had a history of heavy smoking (30 or more pack-years) and who currently smoke or who quit within the past 15 years.

Before this recommendation, data from the 2010 National Health Interview Survey (NHIS) showed that only 2% to 4% of high-risk smokers had received LDCT screening in the past year.

The current study provides the first national estimate of LDCT screening in this high-risk group after the USPSTF recommendations were released in 2013.

To see whether LDCT screening changed since then, researchers compared responses to the NHIS between 2010 and 2015. The analysis included data from 2167 adults who met USPSTF criteria for lung cancer screening, who did not have a history of lung cancer, and for whom LDCT testing data were available.

Between 2010 and 2015, rates of LDCT screening in the past year stayed about the same: 3.3% in 2010 and 3.9% in 2015 (P = .60).

More than 50% of smokers who met USPSFT criteria for screening were uninsured or were Medicaid recipients.

The study may have limited by the fact that the study respondents self-reported their smoking history and whether they had received LDCT screening in the past year.

The study was supported by the American Cancer Society. The authors have disclosed no relevant financial relationships.

JAMA Oncol. Published online February 2, 2017. Abstract

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