Lung Cancer Screenings Can Save Lives, Yet Uptake Remains Low

Findings from a study published in JAMA Network Open show that primary care involvement could create a barrier for lung cancer screenings as many US adults lack access to a primary care practitioner. This access challenge increases risk for preventable deaths as lung cancer screenings are ranked one of the most effective screenings available, saving 1 person’s life for every 320 screening computed tomography scans completed.¹

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According to the American Cancer Society (ACS), an estimated 234,580 individuals in the US will be diagnosed with lung cancer in 2023, which is 11.7% of all new cancer cases. Additionally, ACS estimated that 125,070 individuals in the US will die from lung cancer, which is 20.4% of all cancer deaths.² Individuals diagnosed with lung cancer only face a 5-year survival rate, occurring in 26.7% of cases.³ However, as of October 2024, the FDA has approved a total of 90 different treatment options for lung cancer.⁴ Despite this, cancer screenings remain an effective lifesaving option among individuals with lung cancer.¹

Lung cancer screening can detect lung cancer in its early stages, which can be very helpful toward achieving successful results from treatment. The CDC recommends the low-dose computed tomography (LDCT) scan, which is painless and non-invasive and uses a small amount of radiation. The US Preventive Services Task Force (USPSTF) recommends individuals aged 50 to 80 years, individuals that have a 20 pack-year smoking history, and those that currently smoke or quit in the past 15 years be screened annually for lung cancer.⁵

Not only do lung cancer screenings provide early detection benefits, but additionally around 34% of individuals screened display findings that are unrelated to lung cancer that need additional monitoring. This includes adrenal nodule and aortic aneurysm.¹

The study authors noted that less than 10% of the 15 million individuals that are eligible for lung cancer screening in the US will receive screenings, which are usually administered through primary care. However, around one-third of individuals residing in the US do not have a primary care clinician, resulting in patients needing to seek screenings independently through hospitals. In this study, researchers assessed how effectively hospitals connect patients to lung cancer screeings.¹

Investigators first sampled 527 US hospitals before including a random sample of 500 more hospitals. The results displayed that only 51 of the initial 527 hospitals included in the study had the resources to connect individuals to a lung cancer screening, according to study authors.¹

“Calls failed most often because we lacked a primary care clinician’s order (317 calls [60.2%]). Similar results were seen in the random subset of 500 hospitals, irrespective of Commission on Cancer accreditation status or listing on a screening locator website,” said study authors, in a news release.¹

The findings suggest that further efforts need to be made by primary care clinicians and hospitals to urge eligible members of the public to be screened for lung cancer.¹

“There is no single solution to the puzzle of why lung cancer screening is so heartbreakingly underutilized. The primary care issue is clearly not the only answer, as there are likely millions of screen-eligible people with an established primary care practitioner who are not being screened,” said study authors, in a news release.¹

REFERENCES

1. Lung Cancer Screening at US Hospitals for People Lacking Primary Care. JAMA Network Open. October 31, 2024. Accessed October 31, 2024. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2825517?resultClick=24.

2. Key Statistics for Lung Cancer. American Cancer Society. January 29, 2024. Accessed October 31, 2024. https://www.cancer.org/cancer/types/lung-cancer/about/key-statistics.html#:~:text=Lung%20cancer%20(both%20small%20cell,men%20and%2059%2C280%20in%20women).

3. Cancer Stat Facts: Lung and Bronchus Cancer. National Cancer Institute. Accessed October 31, 2024. https://seer.cancer.gov/statfacts/html/lungb.html#:~:text=Estimated%20New%20Cases%20in%202024,26.7%25%202014%E2%80%932020.

4. Lung Cancer Statistics. Lungevity. News release. October 7, 2024. Accessed October 31, 2024. https://www.lungevity.org/for-supporters-advocates/lung-cancer-awareness/lung-cancer-statistics#:~:text=As%20of%20October%203%2C%202024,4.

5. Screening for Lung Cancer. CDC. October 15, 2024. Accessed October 31, 2024. https://www.cdc.gov/lung-cancer/screening/index.html#:~:text=The%20only%20recommended%20screening%20test,a%20day%20for%2010%20years.