Lung Cancer Screening Uptake under the Revised United States Preventive Services Task Force Guideline: Assessing Disparities.

Background: Scanning with low-dose computed tomography reduces lung cancer mortality by 20% among high-risk individuals. Despite its efficacy, the uptake of lung cancer screening (LCS) remains low. Our study aimed to estimate state-level and nationwide LCS rates among eligible individuals and to assess disparities in LCS uptake.

Methods: Data for this study were obtained from the 2022 Behavioral Risk Factor Surveillance System. Multivariable logistic regression models were used to model the associations between predictors and outcome variables and to examine LCS variability across states.

Results: Of the 28,071 participants eligible for LCS, 17.24% underwent LCS. Participants ages 65 to 79 years were [OR, 1.75; 95% confidence interval (CI), 1.54-1.99] more likely to undergo LCS than their younger counterparts. Those who were female (OR, 0.83; 95% CI, 0.73-0.94); divorced, separated, or widowed (OR, 0.85; 95% CI, 0.74-0.98); without health insurance (OR, 0.34; 95% CI, 0.22-0.53); without a primary care provider (OR, 0.29; 95% CI, 0.19-0.44); and without chronic obstructive pulmonary disease or those who did not disclose their chronic obstructive pulmonary disease status (OR, 0.35; 95% CI, 0.31-0.40 and OR, 0.37; 95% CI, 0.19-0.73, respectively) were less likely to undergo LCS than their respective counterparts. LCS uptake also varied significantly across U.S. states.

Conclusions: We observed a low uptake of LCS overall and significant variability in LCS uptake by sociodemographic and health-related factors, as well as by state of residence.

Impact: The findings from this study have important implications for community health workers and healthcare clinicians and indicate the need to design effective interventions to increase LCS uptake, targeting specific subgroups of populations and particular U.S. states. See related In the Spotlight, p. 9.