94% of patients at high risk for lung cancer failed to undergo LDCT screening

Out of an estimated population of 8 million at high risk for lung cancer, only 5.7% underwent low-dose CT screening in 2019, according to a new report published Tuesday.

There is also widespread imaging variation in this patient population from one state to the next, with rates as high as 18.5% in Massachusetts, down to 1% in Nevada. The numbers highlight the daunting task radiologists and other providers must tackle to begin addressing this “silent killer,” according to the American Lung Association’s third annual report on the disease.

“The ‘State of Lung Cancer’ highlights that too many people are being left behind when it comes to making progress against lung cancer,” ALA President and Chief Executive Officer Harold Wimmer said in a statement. “To turn the tide against this deadly disease, Congress needs to protect and expand access to quality and affordable healthcare that helps more people who may be at high risk get screened and ensures that those diagnosed have access to treatment.”

For the report, authors used data from North American Association of Central Cancer Registries and the American College of Radiology’s National Data Registry, among other sources. This year’s version was the first to also explore the lung cancer burden among racial and ethnic minority groups at both national and state levels.

Experts noted that people of color diagnosed with lung cancer face much worse outcomes than their white counterparts. Early diagnosis rates among the Black population were 16% lower, for instance, and 13% for Latino patients. Black and indigenous patient also saw a 19% lower rate of surgical treatment versus whites, while Latinos recorded a 39% higher rate of “no treatment.”

Payment has served as one barrier to greater low-dose CT use. State Medicaid programs are one of the only healthcare payers not required to cover lung cancer screenings, the authors noted. Thirty-eight states do provide fee-for-service payments, while nine such programs do not. Those include Alabama, Alaska, Florida, Mississippi, Nebraska, North Dakota, Texas, Utah, Wyoming. The ACR has also highlighted low Medicare rates as an additional barrier to LDCT.

“No one who wants treatment should have to forgo care due to lack of access or cost of treatment,” Wimmer added.

You can read the full report from the American Lung Association here.