• Among approximately 13.17 million U.S. individuals meeting lung cancer screening criteria, only 18.1% were screened.
• The majority of adults meeting criteria were unaware of lung cancer screening availability.

PHOENIX — In 2022, the proportion of eligible U.S. adults screened for lung cancer was lower than the proportions screened for breast cancer and colorectal cancer, according to results presented at the CHEST Annual Meeting.

“Lung cancer screening is a shared responsibility, not something that belongs to pulmonology alone,” Sarvesh Sharma, MD, pulmonary disease and critical care medicine fellow at Cape Fear Valley Medical Center and clinical instructor at Methodist University Cape Fear Valley School of Medicine, told Healio. “There simply are not enough pulmonologists to close this gap on our own, so every clinician who sees patients with a smoking history has a role to play.

“Practically, that means systematically identifying eligible patients, making a clinician-initiated conversation about lung cancer risk the default rather than the exception, and raising patient awareness that screening exists,” Sharma said. “The payoff is real. When we catch disease early instead of late and incidentally, we get meaningfully better outcomes.

Using publicly reported U.S. national surveillance datasets from 2022, Sharma and colleagues evaluated several factors related to lung cancer screening — uptake, patient awareness, clinician-patient communication, access and how uptake compares with other cancers — in a descriptive, cross-sectional synthesis.

“At our facility, the majority of lung nodules were being found late and often incidentally, rather than through screening,” Sharma told Healio. “That raised an obvious question for us: Was this a local problem unique to our patients and referral patterns, or a reflection of something happening nationally?

“Rather than assume we were an outlier, we went to the publicly reported national surveillance data to find out where our experience fit into the larger picture,” he said.

The 2022 datasets included the Behavioral Risk Factor Surveillance System (BRFSS) survey for lung cancer screening, which was assessed in a study published in JAMA Internal Medicine in 2024; the American Lung Association Lung Health Barometer; and the BRFSS survey for breast and colorectal cancer screening.

Among approximately 13.17 million individuals meeting the 2021 U.S. Preventative Services Task Force criteria for lung cancer screening (age 50-80 years, 20 or more pack-years and currently smoking or quit within 15 years), only approximately 2.2 million (18.1%) were screened.

Sharma highlighted that the majority of adults meeting screening criteria were unaware of lung cancer screening availability (62%) and had not talked about lung cancer risk with a clinician (73%).

“We went into this largely assuming the problem was ours to fix locally,” Sharma said. “What surprised us was how consistently the same gaps appeared everywhere.

“Seeing our local experience mirrored so closely in the national data was both striking and sobering,” he added.

By insurance type, lung cancer screening uptake was highest among those with Medicare (26.3%), followed by those with Medicaid (16.2%), private insurance (14.4%) and no insurance (3.7%).

Additionally, more adults with vs. without a usual source of care were screened for lung cancer (19.7% vs. 5.1%), according to the study.

When compared with breast cancer and colorectal cancer screening, researchers found that lung cancer screening had the lowest uptake among age-eligible adults (18.1% vs. 76.6% and 61.4%).

“We want to keep a close eye on trends over time rather than capturing a single snapshot,” Sharma told Healio. “Encouragingly, the national data already show [lung cancer screening] uptake rising, from about 12.8% in 2019 to 18.1% in 2022 and 24.5% in 2024, so part of our future work is tracking whether that trajectory continues and which interventions are actually moving the needle.

“We also want to better understand what influences screening uptake, including patient awareness, clinician communication and access to screening,” he continued. “By examining these factors, we hope to identify persistent barriers and determine whether national improvements are also being seen at the local level.”

Sarvesh Sharma, MD, can be reached at drsharmasarvesh@gmail.com.