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. 2019 Jan;56(1):66-73.
doi: 10.1016/j.amepre.2018.07.030. Epub 2018 Nov 19.

Lung Cancer Screening Inconsistent With U.S. Preventive Services Task Force Recommendations

Thomas B Richards  1 , V Paul Doria-Rose  2 , Ashwini Soman  3 , Carrie N Klabunde  4 , Ralph S Caraballo  5 , Simone C Gray  6 , Keisha A Houston  7 , Mary C White  6
Affiliations

Lung Cancer Screening Inconsistent With U.S. Preventive Services Task Force Recommendations

Thomas B Richards et al. Am J Prev Med. 2019 Jan.

Abstract

Introduction: Prior studies suggest overuse of nonrecommended lung cancer screening tests in U.S. community practice and underuse of recommended tests.

Methods: Data from the 2010 and 2015 National Health Interview Surveys was analyzed from 2016 to 2018. Prevalence, populations, and number of chest computed tomography (CT) and chest x-ray tests were estimated for people who did and did not meet U.S. Preventive Services Task Force (USPSTF) criteria for lung cancer screening, among people aged ≥40 years without lung cancer.

Results: In 2015, among those who met USPSTF criteria, 4.4% (95% CI=3.0%, 6.6%), or 360,000 (95% CI=240,000, 535,000) people reported lung cancer screening with a chest CT; and 8.5% (95% CI=6.5%, 11.1%), or 689,000 (95% CI=526,000, 898,000) people reported a chest x ray. Among those who did not meet USPSTF criteria, 2.3% (95% CI=2.0%, 2.6%), or 3,259,000 (95% CI=2,850,000, 3,724,000) people reported a chest x ray; and 1.3% (95% CI=1.1%, 1.5%), or 1,806,000 (95% CI=1,495,000, 2,173,000) people reported a chest CT. The estimated population meeting USPSTF criteria for lung cancer screening in 2015 was 8,098,000 (95% CI=7,533,000, 8,702,000), which was smaller than the 9,620,000 people (95% CI=8,960,000, 10,325,000) in 2010.

Conclusions: The number of adults inappropriately screened for lung cancer greatly exceeds the number screened according to USPSTF recommendations, the prevalence of appropriate lung cancer screening is low, and the population meeting USPSTF criteria is shrinking. To realize the potential benefits of screening, better processes to appropriately triage eligible individuals to screening, plus screening with a USPSTF-recommended test, would be beneficial.

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Figures

Figure 1.
Figure 1.
Population estimates for adults who reported lung cancer screening, 2010 and 2015.a aRespondents are adults aged ≥ 40 years without lung cancer. Estimates are rounded to nearest million. Lung cancer screening categories are not mutually exclusive. CT, computed tomography; USPSTF, U.S. Preventive Services Task Force.
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