Predictors of Up-To-Date Lung Cancer Screening Among Eligible People in the United States: A Nationally Representative Dataset

Abstract

This study examines the factors associated with up-to-date lung cancer screening (UTD-LCS) among eligible adults. We analyzed survey data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) and selected participants eligible for LCS. Logistic regression models were used to examine the relationship between UTD-LCS and various factors, including demographics, mental and physical health, and access to healthcare. Among the respondents (Weighted N = 13,037,747), 8.18% were eligible for LCS. However, only 24.53% of those eligible had undergone screening in the past year. Individuals who self-identified as Asian (OR = 0.77, P = .008), American Indian (OR = 0.78, P = .002), and Hispanic (OR = 0.79, P = .006) were significantly less likely to participate in LCS screening. In contrast, married individuals (OR = 1.07, P = .019) and older adults aged 70 to 80 years (OR = 1.78, P < .001) were more likely to have undergone screening. Additionally, a poor physical health status was associated with UTD-LCS, as having more days of poor health increased the odds of screening (for 14 days or more: OR = 1.28, P < .001). Finally, having insurance (private plan: OR = 3.7, P < .001) and not experiencing medical cost issues (OR = 1.13, P = .025) were also associated with greater odds of being up-to-date on lung cancer screening. Our results underscore the need for targeted public health interventions that increase awareness and accessibility of LCS. The study also emphasizes the critical role of primary care providers in promoting screening.