Percentage Up to Date With Chest Computed Tomography Among Those Eligible for Lung Cancer Screening

Introduction: Authors aimed to calculate the percentage up-to-date with testing in the context of lung cancer screening across 5 healthcare systems and evaluate differences according to patient and health system characteristics. Methods: Lung cancer screening-eligible individuals receiving care within the five systems in the Population-based Research to Optimize the Screening Process Lung consortium from October 1, 2018 to September 30, 2019 were included in analyses. Data collection was completed on June 15, 2021; final analyses were completed on April 1, 2022. Chest computed tomography scans and patient characteristics were obtained through electronic health records and used to calculate the percentage completing a chest computed tomography scan in the previous 12 months (considered up-to-date). The association of patient and healthcare system factors with being up-to-date was evaluated with adjusted prevalence ratios and 95% CIs using log-binomial regression models. Results: There were 29,417 individuals eligible for lung cancer screening as of September 30, 2019; 8,333 (28.3%) were up-to-date with testing. Those aged 65-74 years (prevalence ratio=1.19; CI=1.15, 1.24, versus ages 55-64), those with chronic obstructive pulmonary disease (prevalence ratio=2.05; CI=1.98, 2.13), and those in higher SES census tracts (prevalence ratio=1.22; CI=1.16, 1.30, highest quintile versus lowest) were more likely to be up-to-date. Currently smoking (preva-lence ratio=0.91; CI=0.88, 0.95), having a BMI & GE;30 kg/m2 (prevalence ratio=0.83; CI=0.77, 0.88), identifying as Native Hawaiian or other Pacific Islander (prevalence ratio=0.79; CI=0.68, 0.92), and having a decentralized lung cancer screening program (prevalence ratio=0.77; CI=0.74, 0.80) were inversely associated with being up-to-date. Conclusions: The percentage up-to-date with testing among those eligible for lung cancer screen-ing is well below up-to-date estimates for other types of cancer screening, and disparities in lung cancer screening participation remain. Am J Prev Med 2023;65(1):126-130. & COPY; 2023 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Automated summary

The authors aimed to determine the percentage of individuals up-to-date with lung cancer screening testing and evaluate differences based on patient and health system characteristics. The study found that only 28.3% of eligible individuals were up-to-date with testing. Factors associated with being up-to-date included age, chronic obstructive pulmonary disease, socioeconomic status, while factors inversely associated included smoking, BMI, ethnicity, and the type of lung cancer screening program.