Annual Lung Cancer Screenings Still Lacking Among Heavy Smokers

Despite United States Preventive Services Task Force (USPSTF) recommendations for current and former smokers to undergo annual low-dose computed tomography (LDCT) lung cancer screenings, a study published in JAMA Oncology found that screening rates still remain low.

In December 2013, the USPSTF recommended annual LDCT screenings for asymptomatic smokers aged 55 to 80 years who have a 30-pack or more per year smoking history, and who currently smoke or have quit within the past 15 years.

A study conducted by the National Health Interview Survey (NHIS) in 2010 showed that only 2% to 4% of high-risk smokers received LDCT in the year prior. For the study, the investigators sought to examine whether LDCT screening had increased following the USPSTF recommendation.

The investigators compared responses from the 2010 and 2015 NHIS, which included 2347 respondents who would meet the USPSTF requirements for LDCT screening.

From 2010 to 2015, the results of the study showed that the percentage of eligible smokers who reported LDCT screening in the past 12 months remained low and constant, from 3.3% in 2010 to 3.9% in 2015. Additionally, there was an even lower proportion of noneligible smokers who received LDCT.

The investigators estimated that of the 6.8 million smokers eligible for screening in 2015, only 262,700 received LDCT. Overall, there were no significant increases in screening from 2010 to 2015 among the sociodemographic groups. According to the study, there were no significant subgroup differences in screening, excluding participants with or without a history of bronchitis.

The authors noted that more than 50% of smokers who met the USPSTF recommendations for LDCT screening were uninsured or on Medicaid.

“The reasons for the low-uptake in screening are probably varied, and likely included lack of knowledge among both smokers and doctors as to screening recommendations as well as access to high-quality screening,” said lead investigator Ahmedin Jemal, DVM, PhD. “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 risk of screening, so patients can make an informed decision.”