Less Than 1 In 5 Americans Who Are Eligible Are Getting Screen For Lung Cancer. Here’s Why

Less than 20% (19.6%) of Americans who are eligible to get screened for lung cancer are getting the test they need, according to research published in JAMA Network Open.

This is in stark contrast to 70-75% of Americans that get screened for other cancers through tests such as mammograms for breast cancer or colonoscopies for colon cancer. Low screening rates for lung cancer is concerning because lung cancer is the deadliest of all cancers, and nearly half of those with the disease get diagnosed when it has already spread outside the lung and survival is low, according to the CDC.

So why are lung cancer screening rates so abysmal? The answer is not straightforward and likely a result of multiple factors.

For starters, many Americans are not even aware there is a screening test for lung cancer or who is actually eligible. A low dose CT scan of the chest is the only method to get screened for lung cancer, and involves a special type of x-rays that take pictures of your lungs while lying flat on a table and going through a machine. Annual screening should occur for those between the ages of 50 and 80, who have a 20 or more pack-year history of smoking, and currently smoke or have quit within the past 15 years.

According to a 2023 Early Detection Survey administered by Prevent Cancer Foundation, two in five respondents were unable to identify the accurate description of a lung cancer screening test, and 44% did not understand the definition of a pack-year smoking history. This confusion about what the specific screening test is and who is actually eligible could be a significant barrier for the many that really could benefit from the test.

For clarification, a 20 pack-year smoking history means smoking one pack of cigarettes a day for 20 years, or smoking 2 packs a day for 10 years.

There may also be barriers from primary care physicians themselves, as many are not having discussions with their patients about lung cancer screening. In some reports, less than 10% of physicians regularly discuss lung cancer screening with their patients according to research published in Cancer Epidemiology, Biomarkers & Prevention. This underscores the need for physicians to understand lung cancer screening recommendations as well as to counsel patients on its importance.

Although Medicare and most private insurance companies cover lung cancer screening for those eligible, there can still be significant barriers to get the test. Although the vast majority of states cover low dose CT screening through Medicaid, several states still require prior authorization or a copay before receiving the test. This can result in unnecessary barriers for individuals from receiving a life-saving test.Finally, the stigma surrounding smoking, the most common risk factor for lung cancer, can also contribute to low screening rates. Many current or prior smokers may feel judged or embarrassed by seeking screening, despite the clear benefits associated with early screening. Being labeled as a smoker by health care professionals or friends can result in undue anxiety and embarrassment for many.

Addressing all of these barriers is crucial in order to improve screening rates for lung cancer. This can be done by having experts provide clear messaging on eligibility criteria, which would in turn increase awareness about how deadly lung cancer really is. In addition, healthcare providers must be proactive in discussing the benefits and risks of lung cancer screening with patients, particularly those at increased risk. Expanding access to screening, especially in underserved and rural areas could also allow more to benefit from a live-saving test. Finally, decreasing the stigma by normalizing screening could help people feel more comfortable in receiving the lung cancer screening study.

Screening with annual low dose CT scans can reduce lung cancer deaths by 20% according to the American Lung Association. We need to do better to save more lives.