Awareness of lung cancer screening remains low | Music

There is a lung cancer screening test that is saving lives, but most people who might be tested have never heard of it or talked to their doctor about it.

“We have effective screening tests that are as effective or more effective in reducing mortality than breast cancer and colorectal cancer screenings, which are more effective than those two combined. “It's one of the most life-saving measures we have for a cancer that kills people,” said the lung cancer pulmonologist. Dr. Gerald Silvestri. Still, he said, “regardless of race, education, ethnicity, health status, or income, 80% of people eligible for this screening have never heard of lung cancer screening or discussed it with a clinician.” said.

Silvestri is the lead author on new publications from the group: MUSC Hollings Cancer Center Researchers investigating awareness of the existence of lung cancer screening. This paper is published this week JAMA network open.

Lung cancer screening consists of a low-dose CT scan of the lungs. It is a non-invasive, painless test and does not require anesthesia. This scan can detect lung cancer in its early stages and can often be completely removed with surgery. Importantly, eligible patients must have annual scans so doctors can spot changes.

Nationwide, less than one-fifth of those eligible for testing have been tested.

“Overall, overall lung cancer screening uptake rates are between 16% and 20%, which is an optimistic estimate,” Silvestri said.

Cancer disparities researcher and first author Dr. Kalyani Sonawanesaid the group wanted to know better how many people have heard of lung cancer screening.

“Lung cancer screening has been recommended for some time, but uptake is very low,” she says. “When you think about screenings, the most basic expectation is that there is some communication that screenings exist. So we need to give the public knowledge and awareness, and we need to provide the public with knowledge and awareness, and with other preventive interventions. Similarly, communicating information is part of the healthcare provider's responsibility.”

The group used data from an ongoing survey conducted by the National Cancer Institute that asks about people's knowledge and perceptions about cancer and other health issues.

Among former smokers, 18% had never heard of lung cancer testing and 75% had never talked to a clinician about it. Among current cigarette smokers, 14% had never heard of lung cancer testing and 71% had never talked to a clinician about it.

Sonawane pointed out that the way the survey questions are worded requires people to choose one answer. Some people who have not talked to their clinician about this may not even know about this test. And in fact, a previous American Lung Association survey that asked similar questions found that 73% had never talked to their doctor about their lung cancer risk. Physicians and 62% were not familiar with lung cancer screening.

“I'd like to say I was surprised by this result, but I don't think lung cancer screening is as popular as colon cancer screening,” he said. Dr. Benjamin Tollco-director Lung cancer screening program at MUSCdirector of MUSC Healthy Tobacco Treatment Program He is also a co-author of the paper.

“It would be great if we could encourage our doctors, especially GPs, to promote this as a screening method, especially for people who currently smoke,” he said.

Although increasing conversations about lung cancer screening during primary care visits is an area of ​​opportunity, the researchers also acknowledged that primary care physicians are already under strain.

“Our GPs have so many screening tests and so many things to do that it’s hard to prioritize what to do and when to do it. We have a long list and maybe a 20-minute We have time. It's really hard to get it all done,” Toll said.

Additionally, the group of people targeted by this screening test also happens to be one that is particularly difficult to reach, Silvestri said.

“Smoking itself is an indicator of inequality. Research shows that smokers tend to have lower incomes, live in rural areas, have less education, and are less likely to have a primary care physician, all of which play a role. '' he said. This group will be harder to reach.

Because this test does not necessarily exist in tests for other types of cancer, there may be some anxiety.

“I've noticed that among the patients I've helped quit smoking, there's a stigma because they're worried that they're going to get lung cancer,” Toll said. “I do not entirely agree with the claim that patients 'gave themselves lung cancer' in that tobacco companies have been treating patients' cigarettes to make them addictive for decades. , in my opinion they took some of the choice away from the end user.

Silvestri said many organizations are working to incorporate lung cancer screening reminders into electronic health records, but this is more difficult to operationalize than adding reminders for other types of screenings.

For example, a colon cancer screening reminder only requires the patient's date of birth. This is because colon cancer screening is recommended for everyone starting at age 45.

But lung cancer screening depends on a combination of age and “pack years,” which are calculated based on how many packs of cigarettes a person smokes in a day, and this detailed information is often not included in electronic health records. Silvestri said the MUSC testing program is working with electronic medical record vendors to improve the specificity of information in records.

But even without such information, MUSC has steadily expanded its lung cancer screening program.

“We are testing more people across the state and we look forward to that,” Silvestri said. “We found that the diagnosis rate was 3.3%. More importantly, most of them are in the early stages, so they are likely to be cured.”

Lung cancer screening guidelines

Talk to your health care provider about the following conditions: I was tested for lung cancer. If you do:

• Their ages range from 50 to 80 years old.

• I have a history of smoking 20 packs a year: 1 pack a day for 20 years. For example, 2 packs a day for 10 years.
• Currently smoke or have quit within the past 15 years.

Sonawane K, Garg A, Thor BA, Deshmukh AA, Silvestri GA. Lung Cancer Screening Communication in the United States, 2022. JAMA Netw Open. 2024;7(11):e2442811. doi:10.1001/jamanetworkopen.2024.42811

Research reported in this publication was supported by a Hollings Cancer Center Postdoctoral Fellowship and the National Institutes of Health under award number P30CA138313. The funder had no role in the design and conduct of the study. Data collection, management, analysis, and interpretation. Manuscript preparation, review, or approval. and the decision to submit the manuscript for publication.