Key Takeaways
- A newly published study found that less than one in five people considered at high risk of developing lung cancer are getting tested as often as they need to.
- The study came from a team at the American Cancer Society.
- Experts say increased awareness, infrastructure and resources are all part of the picture in increasing these rates.
New research published in Zama show Lung cancer screening rates in the United States are not ideal. Researchers at the American Cancer Society found that less than one in five Americans at high risk for lung cancer are keeping an optimal annual screening schedule.
Those at higher risk include people ages 50 to 80 who smoke or have smoked a pack of cigarettes a day for 20 years. People who quit smoking less than 15 years ago are still considered at high risk. The goal is for people at high risk to be screened with a CT scan every year.
The United States Preventive Services Task Force (USPSTF) implemented screening recommendations in 2014. Previously, the task force said there was insufficient evidence to recommend for or against screening.
Priti Bandi, Ph.D., one of the study's authors who serves as scientific director of the American Cancer Society's Division of Risk Factors and Screening Research, said the study provides some data on how well screening guidelines are working. They say it bridges the gap.
“Fast forward 10 years. [after the recommendation change], we know very little about how these tests are utilized in the U.S. adult population,” Bandi told Verywell. “This is because the large national surveys we use to track these behaviors do not measure lung cancer screening well over time.”
This research landscape changed when the 2022 National Survey of Health-Related Risk Behaviors began asking respondents in every state about lung cancer screening.
Bandi said previous research has shown that lung cancer screening rates in this high-risk population ranged from 6.5% to 15% in 2020, with that number rising to 18.1%. Bandi said the jump was a “pleasant surprise” for her and her team, but the stark differences between states remain a problem. For example, better screening rates in the Northeast account for a significant portion of the increase in the national average.
Calculating screening rates is important because early detection has a significant impact on lung cancer mortality.
“We know that lung cancer remains a leading cause of disease. [cancer-related] “He died in the United States,” he said. “We also know that intervening at an early stage is associated with much better survival. Lung cancer screening is primarily an early detection tool. “Detecting cancer early can prevent cancer deaths.”
The 5-year survival rate for non-small cell lung cancer is over 60% when diagnosed at a local stage, whereas it is only 8% when diagnosed at a distant stage.
Why is my testing rate so low?
According to estimates by the National Cancer Institute, lung cancer is expected to account for 11.7% of all cancer cases and 20.4% of all cancer deaths this year. So why are testing rates so low? Dr. Fernando Santini, a thoracic oncologist at Memorial Sloan Kettering Cancer Center, said it's a combination of factors.
“The first big hurdle and challenge is finding those patients and actually training them to perform a CT scan. The second hurdle is finding a place where you can do that,” Santini told Verywell. “Then there are the issues of insurance and reimbursement.”
Bandi agrees that it's not as simple as telling people they need to go for a scan. Structural problems must also be resolved.
“It requires dedicated facilities and capabilities. This includes not only the physical infrastructure of the building, but also the doctors being trained to read these radiology images,” she said. “It’s a lot better than before, but it’s not scalable to the entire population.”
Geographical and regional differences
Of the 10 states that have not expanded Medicaid, half have significantly lower annual lung cancer screening rates than the rest, including Georgia, Mississippi, Tennessee, Texas, and Wyoming.
The state with the highest percentage of people with up-to-date testing is Rhode Island, at 31%. Wyoming had the lowest at 9.7%. Santini said lung cancer screening through CT scans is important because it can be a way to identify other health conditions.
“The message to all policymakers is that a state-based and national effort is needed to improve access to comprehensive cancer screening, including lung cancer screening,” Bandi said.
The benefits of an annual CT scan for smokers go beyond detecting lung cancer.
“The primary goal is to find lung nodules, but CT scans can also help identify lung diseases such as COPD or coronary artery calcification,” Santini said. “We need to make the most of these visits.”
What this means to you
If you are eligible for an annual lung cancer screening but have not yet had one, you should talk to your health care professional.