How radiologists can use mammography to improve lung cancer screening utilization

Many women who undergo screening mammography are also eligible for lung cancer screening (LCS), according to a new study published by the Journal of the American College of Radiology. Yet LCS utilization in the United States remains considerably low.  

“LCS with low-dose CT has been shown to reduce deaths from lung cancer by 15% to 20% in high-risk current or former smokers,” wrote Diego López, MPH, Harvard Medical School in Boston, and colleagues. “The United States Preventive Services Task Force recommends annual screening for this patient population; however, general awareness of these guidelines is suboptimal.”

The authors explored a representative sample of 2015 data from the National Health Interview Survey, calculating how many women between the ages of 55 and 74 years old underwent a mammogram within a two-year span and were eligible for LCS. Patients with a history of breast cancer or lung cancer were excluded.

Overall, López and colleagues found that 7.1% of women who underwent a screening mammogram were eligible for LCS and 9.8% were current smokers. That 7.1% extrapolates to more than 1.6 million women throughout the United States. In addition, 58% of women eligible for LCS received mammography within that two-year window.

These statistics, the authors noted, show that imaging providers have an opportunity to provide additional care by communicating with patients who undergo screening mammograms.

“A large number of LCS-eligible women are undergoing screening mammography yet are not participating in LCS,” they wrote. “By leveraging mammography appointments, radiology practices can collaborate to improve LCS participation and enhanced smoking cessation efforts in a patient population already engaged in imaging-based cancer screening services.”

López et al. also provided specific examples of what “leveraging mammography appointments” could look like.

“Radiology practices could collaborate with primary care practices and engage community leaders to develop culturally appropriate LCS educational materials available in waiting areas for screening mammography,” the authors wrote. “Additionally, routine imaging intake questionnaires can be used to identify patients who may be eligible for LCS or smoking cessation counseling. In collaboration with primary care practices, radiology departments can employ patient navigators and front desk staff to enroll eligible patients in LCS or tobacco cessation programs.”