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Smokers Underuse Life-Saving Screening for Lung Cancer

Low-dose CT screening for lung cancer can detect tumors early and significantly improve survival. However, few smokers or ex-smokers are taking advantage of this critical test.

In the United States, lung cancer is the second most common type of cancer and the leading cause of cancer death. One of the most effective ways to diagnose lung cancer early, when it's most treatable, is with a low-dose computed tomography (LDCT) scan. According to the American Lung Association, the 5-year survival rate can improve by 65% if lung cancer is detected before it has spread.

The American Cancer Society recently updated its LDCT screening guidelines to include more individuals at risk of developing the disease. The guidelines recommend that people aged 50 to 80 who smoke or quit smoking less than 15 years ago and have at least a 20-pack-year smoking history should get a yearly LDCT scan.

This recommendation is also endorsed by the United States Preventive Services Task Force (USPSTF).

However, a new American Cancer Society analysis has revealed that most eligible smokers and former smokers are not getting this critical screening.

Lung cancer screening rates remain low

The study, published on June 10 in JAMA Internal Medicine, analyzed data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS), a population-based, nationwide, state-representative survey.

The data showed that among 25,958 people eligible for lung cancer screening, 61.5% reported currently smoking, yet only 18% were up to date with low-dose CT scan screening. The rates varied from 9.7% to 31% among states and were lower in Southern states with the highest rates of lung cancer mortality.

Moreover, only 1 in 20 people without insurance or a source of healthcare were up to date with low-dose CT scans. Still, state-level Medicaid expansions and higher screening capacity levels were associated with more people getting screened.

In addition, the analysis showed that older people and those with more than one health condition were more likely to be up to date with lung cancer screening.

"Although lung cancer screening rates continue to be considerably low, this research does show an improvement over screening rates reported for previous years," said Dr. Priti Bandi, the scientific director of cancer risk factors and screening surveillance research at the American Cancer Society, in a news release. "But we clearly still have a long way to go. We must push harder to move the needle in the right direction."

Health insurance may cover low-dose CT lung cancer screening for eligible individuals. The American Lung Association has created an interactive tool that people can use to check whether specific insurance plans cover this critical test. In addition, the association also developed an eligibility quiz to help people determine if they should talk to their doctor about getting screened.

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