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Lung Cancer Screening Inconsistent With U.S. Preventive Services Task Force Recommendations.

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Lung cancer screening guidelines are not followed, with more people getting inappropriate tests than recommended ones. The number of eligible individuals for screening is also decreasing.

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Area of Science:

  • Pulmonology
  • Radiology
  • Preventive Medicine

Background:

  • Prior studies indicate a trend of both overuse of non-recommended and underuse of recommended lung cancer screening tests in U.S. community practice.
  • Lung cancer screening aims to detect the disease early in high-risk individuals.

Purpose of the Study:

  • To analyze the prevalence and populations undergoing lung cancer screening using chest computed tomography (CT) and chest x-ray.
  • To compare screening practices against the U.S. Preventive Services Task Force (USPSTF) criteria for lung cancer screening.

Main Methods:

  • Analysis of data from the 2010 and 2015 National Health Interview Surveys (2016-2018).
  • Estimation of prevalence and number of chest CT and chest x-ray tests.
  • Focus on individuals aged 40 years and older without a lung cancer diagnosis.

Main Results:

  • In 2015, among those meeting USPSTF criteria, 4.4% received chest CT and 8.5% received chest x-ray for lung cancer screening.
  • Among those not meeting criteria, 2.3% received chest x-ray and 1.3% received chest CT.
  • The population meeting USPSTF criteria decreased from 9.6 million in 2010 to 8.1 million in 2015.

Conclusions:

  • Inappropriate lung cancer screening significantly exceeds appropriate screening based on USPSTF guidelines.
  • The prevalence of appropriate lung cancer screening remains low.
  • A shrinking eligible population and inappropriate screening practices hinder the potential benefits of lung cancer screening programs.