Patient-provider Lung Cancer Screening Discussions: An analysis of a National Survey

Background : The US Preventative Service Task Force (USPSTF) updated their lung cancer screening (LCS) recommendations with annual low-dose CT (LDCT) in 2021. We aimed to assess prevalence of patient-provider discussion about LCS and determine factors associated with such discussions. Materials and Methods : Using data from Health Information National Trends Survey (HINTS) 2022 cycle 6, two cohorts were evaluated: (1) Potentially LCS-eligible, included participants at least 50 years old with a history of current or former smoking and no prior history of lung cancer; (2) LCS-ineligible individuals based on age (e.g., 18 to 49 years old), smoking history (e.g., never smoked) or history of lung cancer. We assessed association of demographic, clinical and social factors with LDCT discussion in a multivariable logistic regression model. Results : Among potentially LCS-eligible patients, 19% had never heard of LDCT and only 9.4% had discussed LCS with their provider within the past year. Those who accessed online patient portals were more likely to discuss LCS with their healthcare provider (OR, 4.25; 95% CI, 1.67, 10.81; P, 0.003), as were respondents with a history of current (vs. former) smoking (OR, 3.15; 95% CI, 1.21, 8.19; P, 0.019). Among LCS-ineligible, 1.9% discussed LCS with their providers. Individuals with a personal history of cancer (OR, 6.70; 95% CI, 1.65, 27.19; P, 0.009), and those who discussed colorectal cancer screening (OR, 5.74; 95% CI, 1.63, 20.14; P, 0.007) were more likely to discuss LCS with their provider. Conclusion : Despite updated USPSTF recommendations, rates of patient-provider LCS remains low. Multi-level interventions to address barriers to LCS are needed.