Lung Cancer Screening Rates Remain Low

radiologist x-raying a patient

Very few people who could benefit from lung cancer screening – mostly current and former smokers – are actually getting the tests, according to findings from American Cancer Society researchers. The authors say this means more patients and health care providers need to be informed about the screening guidelines for lung cancer. The study was published February 2 in JAMA Oncology.

The United States Preventive Services Task Force (USPSTF) began recommending in December 2013 that certain people at high risk for lung cancer have yearly screening with low-dose CT scans. The American Cancer Society study compared the proportion of people who were up-to-date with screening in 2010 – before the recommendation was in effect – to the proportion of people who were up-to-date with screening in 2015 – after the recommendation was in effect.

They found the screening rates to be very low in both years – just 3.3% in 2010 and 3.9% in 2015.  The authors calculate that to mean only 262,700 out of 6.8 million people eligible for lung cancer screening in 2015 received it. Lead author Ahmedin Jemal DVM, PhD said, “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.”

A previous study by Jemal and his colleagues showed that screening everyone eligible could prevent up to 12,000 lung cancer deaths a year in the US.

Lung cancer screening guidelines

The American Cancer Society recommends that doctors talk to their patients about having a low-dose CT scan to check for lung cancer if they meet all of these criteria:

  • 55 to 74 years old
  • In fairly good health (healthy enough to withstand treatment)
  • Have at least a 30 pack-year smoking history (equal to smoking a pack a day for 30 years or 2 packs a day for 15 years)
  • Are either still smoking or have quit smoking within the last 15 years

The screening should be done at facilities that have the right type of CT scanner, a lot of experience using the scanners for lung cancer screening, and a team of specialists who can provide appropriate follow-up care for people whose results indicate a possible problem.

Like all screening, low-dose CT scans of the lungs carry benefits and risks. One drawback of a CT scan is that it finds a lot of abnormalities that turn out not to be cancer but that still need to be checked out to be sure. This may lead to additional scans or even more-invasive tests such as needle biopsies or even surgery to remove a portion of lung in some people. A small number of people who did not end up having cancer have actually died from these tests. The people who are most likely to benefit from screening are those at highest risk for lung cancer, such as people with a long history of smoking.

Because of the risks associated with low-dose CT scanning, and the possibility of doing more harm than good for people who are less likely to have lung cancer, the American Cancer Society recommends doctors discuss screening with people who are at high risk for developing the disease and help them make an informed decision.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Lung Cancer Screening with Low Dose Computed Tomography in the United States, 2010-2015. Published February 2, 2017 in JAMA Oncology. First author Ahmedin Jemal, DVM, PhD, American Cancer Society, Atlanta.

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