Patients eligible for both breast and lung cancer screening are getting mammograms while ditching low-dose CT in droves

Patients eligible for both breast and lung cancer screening are undergoing their mammograms while ignoring low-dose CT in droves, according to new research published Wednesday. 

Radiology providers have struggled to improve screening uptake to curb the country’s leading cause of cancer death. Estimates show that only about 18% of eligible individuals are up-to-date on their LDCT lung screening, far shy of the rates for breast and colorectal cancer. 

Some have suggested that an aversion to preventive healthcare is fueling low rates, but a new analysis published in JAMA pokes holes in this theory. Among 28,483 eligible for lung cancer screening, only about 17%–18% underwent the exam. Conversely, four times more—or 65% of the same group—received their recommended breast and colorectal cancer screening. 

“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.” 

For the study, Potter and colleagues used 2022 data from the CDC’s Behavioral Risk Factor Surveillance System. They pinpointed individuals ages 50 to 70 who were eligible for lung cancer screening based on U.S. Preventive Services Task Force criteria. They also determined whether the same individuals met the guidelines for breast or colorectal screening, too. 

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. 

Potter speculated this gap may be spurred by confusion. 

“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,” she said. “Challenges accessing lung cancer screening clinics are also likely an important factor driving low rates.”

The study’s authors believe their findings underline 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 prevent healthcare,” the authors added.