Rates of Breast and Lung Cancer Screening Differ Among Eligible Patients

Recently published research in JAMA suggests that patients, eligible for both breast and lung cancer screening, are undergoing their mammograms while frequently ignoring low-dose CT.

Radiology providers continue to face challenges in boosting screening uptake to address the nation’s leading cause of cancer death. Estimates show that just 18% of eligible individuals are current with their low-dose computed tomography (LDCT) lung screenings—well below the participation rates seen for breast and colorectal cancer screenings.

While some have pointed to a general aversion to preventive healthcare as a reason for low participation, a recent analysis published in JAMA challenges that assumption. Among 28,483 people eligible for lung cancer screening, only about 17%–18% completed the exam. In contrast, roughly four times that number—or 65%—of the same population received their recommended screenings for breast and colorectal cancer.

“Our findings show that many individuals eligible for lung cancer screenings are open to receiving preventive care services,” lead author Alexandra Potter, a research coordinator with Massachusetts General Hospital, said in an announcement from the Boston-based institution. “The data suggest that these individuals aren’t necessarily resistant to receiving cancer screenings—other factors are likely driving low rates of lung cancer screening.” 

Using 2022 data from the CDC’s Behavioral Risk Factor Surveillance System, researchers identified individuals ages 50 to 70 who were eligible for lung cancer screening based on U.S. Preventive Services Task Force criteria. These individuals were also deemed to meet the guidelines for breast or colorectal screening.

Among 11,147 individuals eligible for both breast and lung cancer screening, about 65% (or 7,248) underwent BCS while 17% (or 2,000) received LCS. Further analysis showed that the receipt of colorectal and breast cancer screening was at least three times higher than receipt of LCS in nearly all subgroups, the authors noted. 

According to Potter, “In contrast to breast and colorectal cancer screening eligibility criteria, which are based on age alone, lung cancer screening eligibility criteria are more complex and include both age and multiple smoking history requirements. Challenges accessing lung cancer screening clinics are also likely an important factor driving low rates.”

The study’s authors believe their findings identify the need for interventions to increase awareness about LCS and address common obstacles. These include challenges assessing eligibility and reaching screening locations. Their finding that mammography uptake was slightly lower among LCS-eligible individuals compared to those ineligible “may reflect a greater burden of barriers to accessing preventative healthcare,” the authors added.