State-level lung cancer screening rates not aligned with lung cancer burden in the US

November 12, 2020

ATLANTA - NOVEMBER 12, 2020 - A new study reports that state-level lung cancer screening rates were not aligned with lung cancer burden. The report, appearing in JNCI: The Journal of the National Cancer Institute, provides the first population-based state-level screening data for all 50 states and finds lung cancer screening rates varied geographically by state.

Lung cancer continues to be the leading cause of cancer-related death in the United States, with an estimated 135,720 deaths expected in 2020. Lung cancer screening with low-dose CT (LDCT) has the potential to reduce cancer death and has been recommended for people with a heavy smoking history since 2013. However, previous studies show it is underutilized. For this study, investigators led by the American Cancer Society's Dr. Stacey Fedewa, and co-authored by members of the National Lung Cancer Roundtable, examined lung cancer screening with LDCT rates and growth in all 50 states, including Washington D.C., from 2016 to 2018. They also looked at how states' lung cancer screening rates correlated with lung cancer burden, sociodemographic status, and access to lung cancer screening.

"The increasing but low utilization of lung cancer screening reflects both ongoing efforts to screening eligible adults, and the many challenges to do so," said Dr. Fedewa. "Kentucky, which has supported screening implementation efforts, is unique as its screening rates are over twice the national average and four times that of other high lung cancer burden states like West Virginia and Arkansas."

Results show that several Northeastern states with lower lung cancer burden (e.g. Massachusetts, Vermont, New Hampshire with <44 lung cancer deaths per 100,000) had the highest screening rates (12.8%-15.2%), and several southern states with a high burden (e.g. mississippi, west virginia, arkansas>50 lung cancer deaths per 100,000) had lower screening rates (<4%) among eligible adults. A notable exception was Kentucky, which simultaneously holds the nation's highest lung cancer death rate and one of the highest lung cancer screening rates (13.7%).

The authors say their finding shows that while overall lung cancer screening rates increased nationally between 2016-2018, the rate was still low in 2018, with only 5-6% eligible adults in the U.S. receiving lung cancer low-dose CT (LDCT). Relative to the national average, screening rate ratios were lower in 8 states, mostly in the West or South and 50% higher in 13 states, mostly in the Northeast or Midwest with Kentucky as the outlier.

The study also found that compared to the national average, lung cancer screening rates were about 20% lower in states with a high proportion of uninsured adults who smoked and 40% lower in states with a relatively low number of lung cancer screening facilities; suggesting that there may be critical gaps in access to lung cancer screening. According to sociodemographic factors, screening rates were positively correlated with the proportion of smokers who were female and negatively correlated with smokers who were Hispanic. Results showed that states with adults who smoked and are Hispanic had a significantly lower screening rate ratio than the national average.

"Deliberate effort from various stakeholders such as policy makers, cancer control, health systems, and providers are needed to boost lung cancer screening rates among eligible adults with a heavy smoking history, a group facing multiple barriers to lung cancer screening and cancer care," said the authors. "If states know what their lung cancer screening rates are, they can set a goal and track progress toward it."
-end-
Article: Fedewa SA, Kazerooni EA, Studts JL, Smith RA, Bandi P, Goding Sauer A, Cotter M, Sineshaw HM, Jemal A, Silvestri GA. State Variation in Low-Dose CT Scanning for Lung Cancer Screening in the United States. JNCI: The Journal of the National Cancer institute, 2020. DOI: djaa170.

URL upon embargo: http://doi.org/10.1093/jnci/djaa170

American Cancer Society

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.