Missed Opportunities: Laryngologists and Lung Cancer Screening in Early Glottic Cancer Patients

The U.S. Preventive Services Task Force (USPSTF) recommends annual lung cancer screening for adults aged 50-80 years who have a smoking history of at least 20 pack-years and are current smokers or have quit within 15 years. We hypothesized that many patients with T1 and T2 glottic carcinoma who meet lung cancer screening criteria are not being screened secondary to a lack of awareness among laryngologists.

This retrospective, cross-sectional review evaluated lung cancer screening implementation for T1N0 and T2N0 glottic cancer patients at our institution from 1996 to 2023. We compared chest CT utilization based on USPSTF lung cancer screening criteria. A survey was distributed to laryngologists to evaluate provider practice patterns and lung cancer screening awareness.

A total of 133 patients met the inclusion criteria. Of these, 56 met USPSTF lung cancer screening guidelines, and 48% (27/56) received a chest CT. For those who were ineligible for screening, 61% (47/77) received a chest CT. A total of 66 laryngologists completed the survey. Of these, 75% answered that they were "somewhat familiar" or less with USPSTF lung cancer screening guidelines. Thirty-nine percent responded that they never or rarely order imaging for lung cancer screening.

The incidence of SPLC in patients with early glottic cancer is high (5.6%). Patients with laryngeal cancer who meet USPSTF screening guidelines should undergo chest screening for early detection and reduced mortality in this high-risk population. Increased education and awareness among laryngologists are critical to bridge the gap in screening implementation.