Use of Lung Cancer Screening Tests in the United States: Results from the 2010 National Health Interview Survey

Abstract

Background Prior to evidence of efficacy, lung cancer screening was being ordered by many physicians. The National Lung Screening Trial (NLST), which demonstrated a 20 percent reduction in lung cancer mortality among those randomized to receive low-dose computed tomography (LDCT), will likely lead to increased screening use. Methods We estimated the prevalence of chest x-ray and CT use in the United States using data from the 2010 National Health Interview Survey (NHIS). Subjects included 15,537 NHIS respondents aged ≥40 years without prior diagnosis of lung cancer. Estimates of the size of the U. S. population by age and smoking status were calculated. Multivariate logistic regression examined predictors of test use adjusting for potential confounders. Results Twenty-three percent of adults reported chest x-ray in the previous year, and 2.5 percent reported chest x-ray specifically to check for lung cancer; corresponding numbers for chest CT were 7.5 and 1.3 percent. Older age, black race, male gender, smoking, respiratory disease, personal history of cancer, and having health insurance were associated with test use. Approximately 8.7 million adults in the United States would be eligible for LDCT screening according to NLST eligibility criteria. Conclusions and Impact Monitoring of trends in the use of lung screening tests will be vital to assess the impact of NLST and possible changes in lung cancer screening recommendations and insurance coverage in the future. Education of patients by their physicians, and of the general public, may help ensure that screening is used appropriately, in those most likely to benefit.

Attitudes About Lung Cancer Screening: Primary Care Providers Versus Specialists

“…8 This recommendation applies to approximately 8.7 million people in the US, and its implementation could lead to the avoidance of as many as 12,000 lung cancer-associated deaths. 9,10 Both the Centers for Medicare and Medicaid Services (CMS) and the Affordable Care Act provide coverage for lung cancer screening, 11 but this coverage requires that patients receive counseling regarding lung cancer screening in a shared decision-making visit and must include the use of patient decision aids as well as a written referral order from a qualified provider. These requirements for shared decision-making place primary care providers (PCPs) at the forefront of the implementation and success of lung cancer screening programs.…”

Low-Dose CT Lung Cancer Screening Practices and Attitudes among Primary Care Providers at an Academic Medical Center

“…In the United States, it is estimated that 8.7 million adults are eligible for LDCT screening (12) and as many as 12,000 lung-cancer related deaths could be avoided per year with implementation. (13) One study of primary care providers conducted in 2006 to 2007, prior to the publication of the current guidelines recommending LDCT screening, suggested that the use of CT screening tests for lung cancer was low (22%), with higher use of a non-recommended screening test (55% chest x-ray).…”

Utilization of Cessation Resources Among HIV-Positive and HIV-Negative Men Who Smoke and Who Have Sex With Men in Chengdu, China

“…Participants completed a 15-min self-administered paper-and-pencil survey between November 2012 and March 2013. Eligible participants were ≥18 years old, able to provide consent in Mandarin Chinese, had sex with men (oral, anal, both) in their lifetime, had smoked ≥100 cigarettes in their lifetime (Doria-Rose et al, 2012), and had smoked ≥1 cigarette in the past 30 days. The sample consisted of 381 MSM, of whom 350 disclosed their HIV status and 344 (188 HIVpositive and 156 HIV-negative) submitted complete surveys.…”