Lung cancer screening eligibility and use with low‐dose computed tomography: Results from the 2018 Behavioral Risk Factor Surveillance System cross‐sectional survey

• Published in: Cancer Vol. 127; no. 5; pp. 748 - 756
• Main Authors: Narayan, Anand K., Gupta, Yasha, Little, Brent P., Shepard, Joanne O., Flores, Efren J.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.03.2021
• Subjects: Cancer screening; Clinical trials; Computed tomography; computed tomography (CT); Cross-sectional studies; early detection of cancer; imaging; Lung cancer; Medical screening; Oncology; Physicians; Polls & surveys; Regression analysis; Risk analysis; Risk factors; Risk taking; screening; secondary prevention; Smoking; Statistical analysis; Surveillance; Tomography; lung cancer; screening; secondary prevention; computed tomography (CT); early detection of cancer; imaging
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.33322

Background In randomized controlled trials, lung cancer screening with low‐dose chest computed tomography (LCS) has been reported to reduce lung cancer mortality. Although initial studies suggested that only approximately 5% of eligible patients have undergone LCS, recent studies have indicated that use of LCS may be increasing nationwide. The objective of the current study was to estimate recent LCS use using cross‐sectional survey data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) survey. Methods The BRFSS is a nationally representative, cross‐sectional telephone survey of adults in the United States (response rate of approximately 50%). The 2018 BRFSS survey included questions regarding LCS eligibility and use in 8 states. The primary outcome was the percentage of participants (aged 55‐79 years with a smoking history of >30 pack‐years) who reported undergoing LCS. Logistic regression analyses evaluated the association between LCS use and sociodemographic characteristics, adjusted for potential confounders and accounting for complex survey design elements. Results A total of 26,910 participants were included, 9.9% of whom were eligible for LCS (95% CI, 8.8%‐10.6%). Of the eligible patients, 19.2% reported undergoing LCS (95% CI, 14.0%‐24.4%). Approximately 16.4% of current smokers were eligible for LCS (95% CI, 14.2%‐18.6%). In our multiple variable analyses of eligible patients, age, sex, marital status, current smoking status, and race were not found to be associated with statistically significant differences in reported LCS (P > .05). Retired patients, patients with personal physicians, and patients who did not complete a high school education were more likely to report receiving LCS (P < .05). Conclusions Compared with previously published studies, the results of the current study suggested that LCS use is increasing. However, LCS use remains low (19%) among eligible participants. Compared with previously published studies, the results of the current study suggest that the use of lung cancer screening with low‐dose chest computed tomography (LCS) is increasing. However, use of LCS remains low (19%) among eligible participants.