Two new research studies published this week offer slightly conflicting views on the progress of CT lung cancer screening. One study saw the screening adherence rate rising to nearly 25%, while another revealed that screening might not be as effective in the real world as it was in the landmark National Lung Screening Trial.
Low-dose CT lung cancer screening was approved for Medicare reimbursement in 2015 following promising NLST results, but the exam was slow to catch on.
- That’s begun to change as U.S. physicians identify how to get eligible high-risk people into screening, while other countries are launching organized population-based screening programs, Germany being the most recent.
In the first study this week, published in JAMA Internal Medicine, researchers calculated the most recent uptake rate for LDCT lung cancer screening.
- Data from 26.1k people from the BRFSS survey in 2024 were analyzed and compared to 2022 data.
The rate of up-to-date LDCT screening prevalence in 2024…
- Rose six percentage points (24% vs. 18%).
- Differed by just 0.5 percentage points between men and women.
- Was highest and rose the most for people ages 65-69 (33%, increasing by 9 percentage points).
- But still lagged screening rates for other cancers like breast (80%), cervical (75%), and colorectal (67%).
This week’s second study was published in JAMA Network Open and offers additional context, finding that real-world lung screening may not reduce all-cause mortality by as much as what was seen in the NLST.
- Researchers analyzed screening’s effectiveness in a program run by the U.S. Veterans Health Administration, which has one of the more successful lung screening programs in the country.
They compared five-year all-cause mortality rates in the VA program for 732 people who were screened, finding that, compared to NLST…
- Mortality rates were 2.5X higher in the VA population (24% vs. 9.7%).
- VA participants had 3X the mortality risk (HR = 2.98).
VA researchers noted that while their population met the same screening eligibility criteria as NLST, the VA patients were sicker and probably less likely to see as much long-term benefit from LDCT screening.
The Takeaway
This week’s studies are a window into the complex changes underway in CT lung cancer screening. While screening’s rising participation rate is good news, the mortality findings show that estimating screening’s effectiveness is more complex than simply overlaying NLST results on real-world populations.