Lung Cancer Screening among Adults Older than Medicare's Upper Age Eligibility Criteria.

Abstract

Implications on the loss of lung cancer screening (LCS) coverage among Medicare recipients aged 77+ have not been explored. We use a 2022 Behavioral Risk Factor Surveillance System (BRFSS) dataset to examine LCS patterns of screen-eligible adults across three age groups: 65-70, 71-77, 78-79 years. In descriptive analyses, LCS-eligible respondents are compared by screening status across each age category. In regression analyses, we explore various sociodemographic and health-related factors that may help explain age-related differences between these groups. Less than a third of our sample reported LCS in the last year (26.3%). Among eligible respondents, adults aged 78-79 reported the highest LCS rates (32.0%) followed by adults aged 71-77 years (28.3%) and 65-70 years (24.2%). Respondents aged 78-79 and 65-70 years with COPD indicated significantly increased LCS odds (respectively, OR=3.37 [1.12-10.11]; OR=2.91 [1.98-4.27]). Respondents aged 78-79 years with history of a heart attack or kidney disease indicated significantly decreased LCS odds (respectively, OR=0.08 [0.01-0.62]; OR=0.06 [0.01-0.56]). Respondents aged 71-77 years with coronary heart disease indicated a significantly decreased LCS odds (OR=0.54 [0.30-0.96]). Although loss of CMS coverage for LCS is not associated with lower screening among BRFSS adults aged 78-79 years, clinicians should continue to consider the appropriateness of treatment for older LCS eligible adults with chronic health conditions.