‘Troubling’ data show lack of awareness about lung cancer screening

Key takeaways:

• Over 80% of people at high risk for lung cancer were unaware of screening or had not discussed it with a doctor.
• Informational interventions in clinics and communities could improve screening awareness.

Most people at high risk for lung cancer have not discussed screening for the disease with their clinician or have even heard of the test, according to a research letter published in JAMA Network Open.

The findings come despite lung cancer screening demonstrating effectiveness at identifying cancer and reducing related mortality outcomes, a researcher pointed out.

“We’ve got a screening test that works. It works as well, if not better, than breast and colorectal cancer screening in terms of mortality reduction. It's one of the most life-saving things we have for a cancer that kills more people than either of those two combined,” Gerard A. Silvestri, MD, MS, FCCP, a professor of medicine at the Medical University of South Carolina (MUSC) and the study’s senior author, said in a press release.

Silvestri and colleagues noted that physician-patient communication is vital for the uptake of lung cancer screening, which only 18% of eligible patients are up to date on, according to a prior study published in JAMA Internal Medicine.

However, how prevalent communication is between health care providers and at-risk patients “remains unclear,” they wrote.

In the cross-sectional analysis, participants aged 50 to 80 years who formerly smoked (n = 929) or currently smoke (n = 350) were asked whether they had heard of lung cancer screening or had talked about it with a clinician at any point in the past year.

The researchers found that 18.1% (95% CI, 14.8%-21.5%) of people who formerly smoked had never heard of lung cancer screening, whereas 75.1% (95% CI, 70.8%-79.4%) never discussed it with their clinician.

Of people who currently smoke, 13.5% (95% CI, 7.7%-19.4%) had never heard of lung cancer screening and 71.1% (95% CI, 63.2%-78.9%) did not discuss the test with their clinician.

Collectively, more than 80% of participants in both study groups had neither heard of lung cancer screening or discussed it with a clinician, regardless of factors like sex, ethnicity, race, household income, educational attainment and unmet social determinants.

Additionally, over 60% of people with a history of cancer or a comorbid lung did not discuss lung cancer screening with their clinicians.

Silvestri and colleagues underlined the data are “troubling” because 13.1 million people are eligible for lung cancer screening.

“I wish I could say that I was surprised by these findings, but I do not think that [lung cancer screening] has the same level of popularity as colon cancer screening,” Benjamin A. Toll, PhD, codirector of the lung cancer screening program at MUSC and study co-author, said in the release. “I think it'd be great if we could encourage our physicians, especially our primary care doctors, to push this as a screening method, especially for current smokers.”

The researchers also suggested that implementing informational interventions in clinics or communities could improve lung cancer screening awareness and spur clinical decision-making between clinicians and patients.

However, Toll acknowledged the time constraints providers already face when conducting tests.

“Our primary care doctors have so many screening tests and so much to do that it's hard to prioritize what to do when,” he said. “There's a long list, and they have probably 20 minutes. It's really a challenge to get it all done.”

References:

Awareness of lung cancer screening remains low. Available at:https://hollingscancercenter.musc.edu/news/archive/2024/11/04/awareness-of-lung-cancer-screening-remains-low. Published Nov. 4, 2024. Accessed Nov. 15, 2024.
Bandi P, et al. JAMA Intern Med. 2024;doi:10.1001/jamainternmed.2024.1655.
Sonawane K, et al. JAMA Netw Open. 2024;doi:10.1001/jamanetworkopen.2024.42811.