Lung Cancer Screening in the US, 2022

Area of Science:

• Public Health
• Preventive Medicine
• Epidemiology

Background:

• The US Preventive Services Task Force (USPSTF) recommends annual lung cancer screening (LCS) using low-dose computed tomography for individuals aged 50-80 years with a significant smoking history.
• Early detection through LCS aims to reduce lung cancer mortality, but representative data on screening prevalence at the state level are limited.

Purpose of the Study:

• To estimate the current prevalence of up-to-date (UTD) lung cancer screening nationwide and across all US states.
• To identify disparities in UTD-LCS prevalence based on demographics, health status, and geographic location.

Main Methods:

• This cross-sectional study utilized data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS), a nationwide, state-representative survey.
• The analysis included 25,958 respondents aged 50-79 years who met the 2021 USPSTF eligibility criteria for LCS.

Main Results:

• The overall prevalence of UTD-LCS was 18.1%, with significant variation across states (9.7%-31.0%), notably lower in southern states with high lung cancer burden.
• UTD-LCS prevalence increased with age and number of comorbidities. Individuals without insurance or a usual source of care had lower screening rates.
• State Medicaid expansion and higher screening capacity were associated with increased UTD-LCS prevalence.

Conclusions:

• The prevalence of up-to-date lung cancer screening remains low nationally, with substantial geographic and healthcare access disparities.
• State-level initiatives focusing on expanding healthcare access and screening facilities are crucial for improving LCS rates and reducing health inequities.