News | Lung Cancer | May 29, 2019

Vast Majority of Heavy Smokers Not Screened for Lung Cancer

Study finds that despite USPSTF and ASCO recommendations, only 1.9 percent of current and former heavy smokers receives low-dose computed tomography screening in 2016

Vast Majority of Heavy Smokers Not Screened for Lung Cancer

May 29, 2019 — Out of more than 7 million current and former heavy smokers, only 1.9 percent were screened for lung cancer in 2016 despite screening recommendations, according to a new analysis. These numbers come despite U.S. Preventive Services Task Force (USPSTF) and American Society of Clinical Oncology (ASCO) screening recommendations.

This study, the first assessment of lung cancer screening rates since those recommendations were issued in 2013, will be presented at the upcoming 2018 ASCO Annual Meeting, May 31-June 4 in Chicago.

“Lung cancer screening rates are much lower than screening rates for breast and colorectal cancers, which is unfortunate,” said lead study author Danh Pham, M.D., a medical oncologist at the James Graham Brown Cancer Center, University of Louisville, Kentucky. “It is unclear if the screening deficit is due to low provider referral or perhaps patient psychological barriers from fear of diagnosis. Lung cancer is unique in that there may be stigma associated with screening, as some smokers think that if cancer is detected, it would confirm they’ve made a bad lifestyle choice.”

Lung cancer is the leading cause of death from cancer, with an estimated 154,040 deaths projected to occur in 2018 in the United States.1 The USPSTF recommends that people ages 55 to 80 years who are current or former heavy smokers (have smoked at least 30 cigarette pack-years) be screened for lung cancer using low-dose computed tomography (LDCT). Cigarette pack years are calculated by multiplying the number of packs of cigarettes smoked per day by the number of years the person smoked. In 2012, ASCO and the American College of Chest Physicians issued a joint guideline with these same recommendations.

The study’s researchers gathered data from the 2016 American College of Radiology’s Lung Cancer Screening Registry on people who received LDCT at nearly 1,800 accredited screening sites. They compared that data to 2015 National Health Interview Survey estimates of eligible smokers who could be screened based on the USPSTF recommendations. The analysis of the data was based on four U.S. census regions in the country: Northeast, South, Midwest and West. The screening rate was calculated by dividing the number of LDCT scans by the number of smokers eligible for screening per USPSTF recommendations.

The authors found that the South had the most accredited screening sites (663) and the highest numbers of smokers who were eligible for screening (3,072,095). Nonetheless, the screening rate in the South was only 1.6 percent, the second lowest in the country, whereas the West had the lowest rate at 1 percent and the lowest number of accredited screening sites (232). The highest screening rate was in the Northeast (3.5 percent), and the Midwest had the second-highest rate of 1.9 percent.

Nationwide, a total of 1,796 accredited screening centers could have screened 7,612,975 eligible current and former heavy smokers, but only 141,260 people received LDCT screenings (the nationwide screening rate was 1.9 percent). By comparison, about 65 percent of women age 40 or older had a mammogram in 2015.

Approximately 85 percent of the screened current smokers were offered smoking cessation resources, which was documented by providers prior to screening referral. The percentage of current and former heavy smokers offered cessation programs did not vary significantly by census region.

The authors have already started looking at 2017 lung cancer screening rates, and, preliminarily, there is a small overall uptick in screening rates in 2017 across all regions.

“This study makes a strong case that our country needs an effective public service campaign about encouraging lung cancer screening. Public service campaigns from the 1990s encouraged women to get mammograms, saving many lives in subsequent years. We need something similar to encourage current and former heavy smokers to get screened for lung cancer,” said ASCO President Bruce E. Johnson, M.D., FASCO.

For more information: www.asco.org

Related Lung Cancer Content

Physicians, Patients Talking Less About Lung Cancer Screening

VIDEO: Radiation Versus Surgery for Non-Small Cell Lung Cancer

 

Related Content

Examples of chest CT images of COVID-19 (+) patients and visualization of features correlated to COVID-19 positivity. For each pair of images, the left image is a CT image showing the segmented lung used as input for the CNN (convolutional neural network algorithm) model trained on CT images only, and the right image shows the heatmap of pixels that the CNN model classified as having SARS-CoV-2 infection (red indicates higher probability). (a) A 51-year-old female with fever and history of exposure to SARS-

Figure 1: Examples of chest CT images of COVID-19 (+) patients and visualization of features correlated to COVID-19 positivity. For each pair of images, the left image is a CT image showing the segmented lung used as input for the CNN (convolutional neural network algorithm) model trained on CT images only, and the right image shows the heatmap of pixels that the CNN model classified as having SARS-CoV-2 infection (red indicates higher probability). (a) A 51-year-old female with fever and history of exposure to SARS-CoV-2. The CNN model identified abnormal features in the right lower lobe (white color), whereas the two radiologists labeled this CT as negative. (b) A 52-year-old female who had a history of exposure to SARS-CoV-2 and presented with fever and productive cough. Bilateral peripheral ground-glass opacities (arrows) were labeled by the radiologists, and the CNN model predicted positivity based on features in matching areas. (c) A 72-year-old female with exposure history to the animal market in Wuhan presented with fever and productive cough. The segmented CT image shows ground-glass opacity in the anterior aspect of the right lung (arrow), whereas the CNN model labeled this CT as negative. (d) A 59-year-old female with cough and exposure history. The segmented CT image shows no evidence of pneumonia, and the CNN model also labeled this CT as negative.  

News | Coronavirus (COVID-19) | May 19, 2020
May 19, 2020 — Mount Sinai researchers are the first in the country to use...
Advanced imaging data exchange is now live in Colorado due to the partnership of Health Images and the Colorado Regional Health Information Organization

Getty Images

News | Radiology Business | May 18, 2020
May 18, 2020 — 
Radiologists from Shanghai discuss modifying exam process and disinfecting exam room, while outlining personal protection measures during the coronavirus disease outbreak

(HIS = hospital information system, RIS = radiology information system) Image courtesy of American Journal of Roentgenology (AJR)

News | Coronavirus (COVID-19) | May 18, 2020
May 18, 2020 — In an open-access article published ahead-of-print
In a new study to help oncologists address the challenges COVID-19-positive lung cancer patients present, a team of global lung cancer specialists published a review of lung cancer treatments for patients with COVID-19

Getty Images

News | Coronavirus (COVID-19) | May 18, 2020
May 18, 2020 — Lung cancer patients are at heightened risk for...
Now a research team — led by Tohoku University Professor, Wataru Yashiro — has developed a new method using intense synchrotron radiation that produces higher quality images within milliseconds.

How the bent crystal changes the direction of the X-rays. Image courtesy of Tohoku University

News | Computed Tomography (CT) | May 15, 2020
May 15, 2020 — Many will undergo a computed tomogr...
In today’s challenging healthcare environment, radiology departments are often faced with the difficult decision of how to safely image patients who are suspected of being positive with infectious disease. To help hospitals and institutions effectively utilize computed tomography (CT) with these conditions, Canon Medical Systems USA, Inc. introduces a deployable CT with a rapid decontamination solution.
News | Computed Tomography (CT) | May 11, 2020
May 11, 2020 — In today’s challenging healthcare environment, radiology departments are often faced with the difficul
Axial (A) and coronal (B) CT of the abdomen and pelvis with IV contrast in a 57-year-old man with a high clinical suspicion for bowel ischemia. There was generalized small bowel distension and segmental thickening (arrows), with adjacent mesenteric congestion (thin arrow in B), and a small volume of ascites (* in B). Findings are nonspecific but suggestive of early ischemia or infection.

Axial (A) and coronal (B) CT of the abdomen and pelvis with IV contrast in a 57-year-old man with a high clinical suspicion for bowel ischemia. There was generalized small bowel distension and segmental thickening (arrows), with adjacent mesenteric congestion (thin arrow in B), and a small volume of ascites (* in B). Findings are nonspecific but suggestive of early ischemia or infection. Image courtesy of RSNA

News | Coronavirus (COVID-19) | May 11, 2020
May 11, 2020 — Patients with COVID-19 can have b