Despite USPSTF Recommendations, 7 in 8 High-Risk Lung Cancer Patients Do Not Receive Screenings

Current and former smokers have an increased risk for developing lung cancer compared to the general population. For this reason, the U.S. Preventive Services Task Force (USPSTF) recommends that certain people undergo special lung cancer screenings. Despite these recommendations and the known risk factors, seven in eight patients at high risk for developing the disease neglect to get screened.

The findings were published in the Centers for Disease Control and Prevention (CDC)’s Morbidity and Mortality Weekly Report.

According to the report, “The U.S. Preventive Services Task Force (USPSTF) recommends annual lung cancer screening for adults aged 55–80 years who have a ≥30 pack-year cigarette smoking history and currently smoke or have quit <15 years ago.” The Grade B recommendation mandates that health insurance companies cover the costs of these screenings.

To see how much the recommendations are followed in practice, the CDC assessed 2017 Behavioral Risk Factor Surveillance System (BRFSS) data covering 10 states.

BRFSS Lung Cancer Module Shows Most People Skip Screening

BRFSS is a phone survey conducted by state health departments in partnership with the CDC. 2017 was the first year that the survey included an optional module on lung cancer screening questions. A question regarding 12-month history of CT scan was asked with the following response options: “Yes, to check for lung cancer”; “No (did not have a CT scan)”; and “Had a CT scan, but for some other reason.”

The lung cancer module was presented by 10 states with 85,514 respondents in 2017. Factors evaluated included current, former, and never cigarette smoking status, as well as smoking pack-years.

Among the patients contacted through BRFSS, 12.7% of adults aged between 55 and 80 years met the USPSTF screening criteria; of this group, 12.5% reported a one-year CT scan to detect the cancer.

“Public health initiatives to prevent cigarette smoking, increase smoking cessation, and increase lung cancer screening among those who meet USPSTF criteria could help reduce lung cancer mortality. Avoidance of screening inconsistent with USPSTF criteria could reduce the potential for harms such as overdiagnosis and overtreatment. Efforts to educate health care providers regarding the benefits of lung cancer screening and to provide decision support tools might increase appropriate and timely lung cancer screening,” the report concludes.