Radiology Partners study unearths 3 common barriers to lung cancer screening

New research from Rad Partners practice affiliate Desert Radiology has unearthed three common barriers keeping patients from undergoing lung cancer screening. 

Numerous studies have charted poor adherence to low-dose CT, with uptake rates as low as 0.7% in some states. The Las Vegas-based practice and Mountain View Hospital aimed to better understand the reasons why. They administered a questionnaire to 300 high-risk patients in southern Nevada during their screening visits, sharing the results in Cancer Epidemiology [1]. 

Absence of symptoms (38%), not wishing to know that they have cancer (30%) and lack of awareness about their eligibility for imaging (24%) were the top 3 answers, RP experts noted. 

“The challenge is for physicians from both radiology and nonradiology specialties to find solutions to resolve these barriers and establish screening low-dose chest CT as the cornerstone for early detection of lung cancer in high-risk populations,” lead author Sameer Rehman, MD, MBA, a cardiothoracic and interventional rad with Desert Radiology, and colleagues concluded. “Parallels are drawn to the progress that other cancer screening programs have shown in the several decades with the increased rates of enrollment, yet the screening for lung cancer—with its prevalence and even greater mortality—remains in its infancy and requires equal attention as such impact would be resounding.”

RP researchers administered the study between August and February 2023, constructing the 12-item questionnaire based on previous literature related to LDCT barriers. The study population consisted of southern Nevadans between 50 to 77 who met screening criteria in Medicare Part B. Less common barriers included concerns relating to the test (17%), cost (17%) and fear of invasive procedures (11%). 

In the study’s discussion section, Rehman et al. emphasized that efforts should be focused on educating patients to clarify that the “tenet of screening begins with asymptomatic patients.” A possible solution could be including these discussions in the context of a yearly health checkup. Most of those surveyed qualified for annual Medicare wellness exams (74%). These recommendations could be made alongside other screening discussions pertaining to breast, cervical and colorectal cancer. 

The research team also suggested improving education about the reduced radiation risk that comes with low-dose CT (about one-fifth of standard computed tomography). Similar instruction could inform patients about how CT is much less invasive than other screening approaches such as colonoscopy or pap smear. Providers also could work to apprise patients of efforts made in recent years to improve coverage for this critical exam. 

Previous studies have explored an integrated approach to screening, deploying a multidisciplinary team of nonhealthcare members, radiologists and nurses to break through some of these barriers, the authors noted. 

“The overall goal of improving lung cancer rates is multifactorial requiring a concerted effort from many disciplines to tackle the patient psychosocial barriers at the state and national level,” the authors wrote.