Lung cancer screening rates among high-risk smokers have remained low regardless of United States Preventive Services Task Force (USPSTF) recommendations, according to a study published in JAMA Oncology.1

Screening by low-dose computer tomography (LDCT) is recommended for anyone between 55 and 80 years old with a 30 pack per year history of smoking who is a current smoker or quit within the past 15 years. One survey found that in 2010, 2% to 4% of people for whom screening is recommended had a LDCT scan. For this study, researchers compared the 2015 National Health Interview Survey with that of 2010.

No significant increase of screening among eligible people from 2010 to 2015 was found (change of 3.3% to 3.9%). Only 262,700 of the eligible 6.8 million smokers or ex-smokers underwent CT in 2015.


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The authors noted that lack of awareness among both clinicians and patients may have contributed to these results, citing a 2015 survey showing that almost two-thirds of physicians in South Carolina were unaware that Medicare reimburses the costs of screening.2

The stipulations for Medicare reimbursement may, however, preclude some eligible patients undergoing screening. The authors also noted that of 2167 survey respondents included in this study, more than half were uninsured or were insured with Medicaid.

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The authors concluded that screening remains low despite USPSTF recommendations and potential public health benefits. Education of clinicians and patients is recommended to improve informed clinical decision-making.

Reference

  1. Jemal A, Fedewa SA. Lung cancer screening with low-dose computed tomography in the United States—2010 to 2015. JAMA Oncol. 2017 Feb 2. doi: 10.1001/jamaoncol.2016.6416 [Epub ahead of print]
  2. Ersek JL, Eberth JM, McDonnell KK, et al. Knowledge of, attitudes toward, and use of low-dose computed tomography for lung cancer screening among family physicians. Cancer. 2016;122(15):2324-31. doi: 10.1002/cncr.29944