Paltry low-dose CT lung cancer screening numbers signal need for population health strategy shift

Low participation in computed tomography lung cancer screenings may signal the need for a shift in strategy, experts advised Tuesday.

Despite proof that these low-dose CT scans can help to reduce mortality rates, adoption of these health check-ins has lagged for various reasons. That’s been the case in China, where the rate of deaths from lung cancer has skyrocketed by 465% in the last 30 years, researchers noted in JAMA Network Open.

Wanting to better understand these trends, scientists analyzed cancer screening data from some 282,000 eligible participants, logged over a six-year period. With just a 40% participation among those at high risk for the disease, experts believe there is work to be done to help bolster these numbers.

“The low participations rate in the program studied suggests that an improved strategy is needed,” Lan-Wei Guo, PhD, with the Department of Cancer Epidemiology and Prevention at Henan Cancer Hospital, and colleagues wrote Nov. 3. “These findings may provide useful information for designing effective population-based lung cancer screening strategies in the future.”

For their analysis, Guo et al. conducted a cross-sectional study using 2013-2019 data from the Cancer Screening Program in urban China. This covered centers in eight different cities, with participants ranging in age from 40 to 74. All told, the team included 55,428 subjects in their analysis who were deemed high risk for lung cancer. More than 22,000 (or 40.16%) underwent LDCT during the study period. And further analysis found that being a female, former smoker, physically inactive, or having a family history of lung cancer upped one’s chances of using LDCT.

China certainly isn’t alone in these struggles, Guo and co-authors noted. One 2015 survey of some 6.8 million eligible patients in the U.S. found that just 260,000 (or 3.8%) received these scans. “The poor compliance with LDCT screening appears to be a common problem in real-world LDCT screening programs involving large sample populations,” they wrote.

The JAMA study did not delve into the reasons that patients avoid lung cancer checks. But Guo et al. said their results highlight the need for public awareness campaigns to drum up patient visits. The writers also highlighted several strategies that warrant further investigation. Those included optimizing risk assessment scores, exploring the role of less harmful tests as a supplement to LDCT, designing novel risk-adapted screening strategies that cover both high- and low-risk populations, and performing “multifactor interventions targeting multiple levels of care with the purpose of optimizing lung cancer screening acceptance.”

Read more of their analysis in JAMA Network Open here. You can also find further advice on improving lung cancer screening adherence in this Radiology Business story from July.