Researchers conducted a nationwide cross-sectional study to estimate the current prevalence of up-to-date (UTD) lung cancer screenings (LCS) in the 50 states and the District of Columbia.

The authors wrote, “The US Preventive Services Task Force (USPSTF) recommends annual lung cancer screening (LCS) with low-dose computed tomography in high-risk individuals (age 50-80 years, ≥20 pack-years currently smoking or formerly smoked and quit <15 years ago) for early detection of LC. However, representative state-level LCS data are unavailable nationwide.”

For this study, conducted between October 1, 2023, and March 20, 2024, the researchers assessed data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) population-based, nationwide, state-representative survey, which involved respondents aged 50 to 79 years who were eligible for LCS according to 2021 USPSTF criteria.

The primary outcome was established as self-reported UTD-LCS (defined as past-year) prevalence. The researchers employed adjusted prevalence ratios (APRs) and 95% CIs to compare the differences.

Cohort characteristics among 25,958 sample respondents who were eligible for LCS included the following: median [interquartile range] age, 62 [11] years; 61.5% reported currently smoking; 54.4% were male; 64.4% were aged 60 years or older; and 53.0% had a high school education or less.

Overall, the prevalence of UTD-LCS was 18.1% but varied across states (range, 9.7%-31.0%), with relatively lower levels in southern states characterized by a high LC mortality burden. The prevalence of UTD-LCS was directly proportional to increasing age (50-54 years: 6.7%; 70-79 years: 27.1%), and as the number of comorbidities increased (≥3: 24.6%; none: 8.7%).

A total of 3.7% of those without insurance and 5.1% of those without a usual source of care were UTD with LCS, but state-level Medicaid expansions (adjusted prevalence ratio [APR], 2.68; 95% CI, 1.30-5.53) and higher screening capacity levels (high vs. low: APR, 1.93; 95% CI, 1.36-2.75) were linked with higher UTD-LCS prevalence.

Based on their findings, the authors concluded that data from the 2022 BRFSS revealed that the overall prevalence of UTD-LCS was low.

The authors wrote, “Disparities were largest according to health care access and geographically across US states, with low prevalence in southern states with high LC burden. The findings suggest that state-based initiatives to expand access to health care and screening facilities may be associated with improved LCS rates and reduced disparities.”

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