Only 15% of eligible American adults discuss lung cancer screening with their doctors

Lung cancer screenings can save lives by detecting cancer in its early stages, but only 15% of eligible American adults have discussed the screening with their doctors, according to data analysis performed by University of Cincinnati Cancer Center researchers.

Senior author Robert Van Haren, MD, said the findings recently published in the American Journal of Surgery emphasize the need to raise awareness and better educate the public about screening through low-dose computed tomography (CT) scans. A low-dose CT scan is a special kind of X-ray that uses less radiation than a standard CT scan.

What did the study focus on?

Van Haren and colleagues analyzed data collected in the most recent version of the Health Information National Trends Survey (HINTS) conducted by the National Cancer Institute and specifically designed to be a representative sample of people across the United States.

They ask a lot of questions about Americans' health, their behaviors around health, like diet, exercise, smoking, alcohol, and about healthy behaviors, including screenings for lung, breast and colon cancer. There's a lot of information, and it gives you a general picture of what American society thinks about healthcare, healthy behaviors and patients' communication with physicians."

Van Haren, a University of Cincinnati Cancer Center researcher and associate professor of clinical surgery, UC College of Medicine

While only 15% of eligible patients discussed lung cancer screenings with their doctors, Van Haren noted that does represent an increase compared to the last set of HINTS data. 

"It is slowly improving, which is good, but it's still very, very low when you compare it to other screening rates, like colonoscopy or mammograms, that are usually in the 70% to 80% range of people getting screened," he said.

The need to raise awareness of lung cancer screenings is especially acute in the Greater Cincinnati area. Nine out of the 10 counties the Cancer Center primarily serves have higher smoking rates than the national average. Approximately 1 in 3 adults smoke in the region, which is twice the national average.

What can patients expect at their lung screening?

Van Haren said lung cancer screening is probably the easiest of the three most common cancer screening tests. 

"Patients lie down and go through the CT scan device and quickly hold their breath, and we take some pictures of the lungs to make sure they're healthy," he said. "There's no IV, no prep. It's completely noninvasive and very fast and easy."

Who should be screened for lung cancer?

The U.S. Preventive Services Task Force recommends lung cancer screenings using low dose CT scans for adults ages 50 to 80 who have a 20 pack-year smoking history and currently smoke or those who have quit within the past 15 years.

A pack-year is calculated by multiplying the number of packs of cigarettes smoked per day by the number of years they have smoked, with one pack-year equivalent to smoking one pack of cigarettes per day for one year or two packs per day for six months. A 20 pack-year history would mean smoking one pack a day for 20 years.

What are the next steps for UC lung cancer researchers?

Funded by a Cancer Center pilot grant, Van Haren's team is interviewing primary care doctors and patients in the community to identify what barriers and factors are preventing these lifesaving conversations about screening from happening. They hypothesize that stigma and fear around lung cancer, and the relatively new screening method, are some of the issues.

"Low-dose CT screening is relatively new in the last 15 years, and we haven't done a great job of getting the message out that it's here," Van Haren said. "It saves lives by detecting cancer early where we can treat it very successfully."

Long term, Van Haren said he hopes for more community and regional partnerships and a focused awareness campaign to encourage more conversations between patients and doctors, leading to more screenings and more lives saved.