One in four Americans eligible for lung cancer screening (LCS) received it in 2024, but with only a modest improvement over two years prior, according to a research letter published April 27 in JAMA Internal Medicine.
A team led by Todd Burus, PhD, of the University of Kentucky in Lexington analyzed data from the 2024 Behavioral Risk Factor Surveillance System to assess how many eligible adults had received a low-dose CT scan to check for lung cancer in the past year. Among more than 26,000 respondents who met U.S. Preventive Services Task Force (USPSTF) criteria (i.e. adults ages 50 to 80 who are current or recent smokers with a significant smoking history) just under 24.5% were up to date on screening -- a six-percentage-point gain since 2022, with improvements seen across most demographic groups.
But the gains weren't universal. The team observed no meaningful increase among Hispanic adults, non-Hispanic Asian adults, or non-Hispanic Black adults -- all of whom already manifest lower screening rates -- and reported that uninsured individuals made no progress toward increased uptake of lung cancer screening. In contrast, those eligible for LCS who had military-related insurance were 83% more likely to be screened than those with private coverage, which the group suggested highlights the value of structured, coordinated screening programs.
Burus and colleagues also reported variations in state-level LCS rates, ranging, for example, from roughly 13% in South Dakota to more than 38% in Massachusetts, with highest rates concentrated in the Northeast.
"Despite improvements, adherence to annual lung cancer screening remained low and uneven in 2024, underscoring the need to strengthen and expand programs and policies that increase uptake among eligible adults," according to the investigators.
In a second research letter, also published April 27 but in JAMA Network Open, a team led by Alison Rustagi, MD, PhD, of the San Francisco Veterans Affairs Health Care System, noted a different but related concern: even when eligible patients do get screened, they may not benefit as much as trials have suggested.
Rustagi and colleagues compared all-cause mortality among participants in the National Lung Screening Trial -- which reported that screening reduced lung cancer deaths by 20% -- with a cohort of 732 Veterans Health Administration (VA) members who met similar eligibility criteria.
Their key findings were that "older veterans eligible for or receiving LCS had a greater risk of mortality than NLST participants of similar age and tobacco history," and that "the lung cancer mortality reduction from LCS may be smaller in routine care than in the NLST."
"Programs to expand LCS may not achieve their full potential without concerted efforts to screen those most likely to benefit," the group warned.
Access both research letters here and here.
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