Lung cancer screening rates in the United States: Contribution of the 2020 NHIS estimates to national and state level trends.

Abstract

Introduction: The United States Preventive Services Task Force (USPSTF) has recommended annual lung cancer screening (LCS) with low-dose computed tomography (LDCT) since 2013 for eligible populations who currently smoke or have formerly smoked. However, U.S. LCS rates from different studies have been inconsistent, and limited data are available for trend analysis.

Methods: Using LCS data from the 2020 National Health Interview Survey (NHIS) and the 2022-2023 Behavioral Risk Factor Surveillance System (BRFSS), we estimated recent LCS rates among eligible adults. We also analyzed data from previous years to examine trends from 2010 to 2023.

Results: Based on NHIS data, an estimated 8,247,101 (95% CI: 7,634,267-8,859,936) U.S. adults were eligible for LCS in 2020 per the 2013 USPSTF criteria. A similar number (8,039,236) were estimated in 2022 from BRFSS using the same eligibility criteria, with an additional 5,364,797 newly eligible individuals based on expanded 2021 USPSTF criteria. LCS rates based on the 2013 criteria increased significantly from 3.8% in 2010 to 15.9% in 2020 (NHIS data), and to 21.8% in 2022 (BRFSS data). However, the 2022 screening rate among the newly eligible population (13.0%) was lower than that of individuals eligible under the 2013 criteria.

Conclusions: The 2020 NHIS estimates contributed to understanding trends in LCS rates, while indicating that the Healthy People 2030 target of 7.5% of eligible screened would benefit from reassessment. Despite significant increases over the past decade, overall LCS rates remain low, and further research is needed to better understand the modest U.S. uptake of lung cancer screening.