Patient-clinician discussions on lung cancer screening in the United States before and after 2021 guidelines

Background Screening for lung cancer via low-dose computed tomography of the chest can promote early detection and reduce mortality. However, since the United States Preventive Service Task Force (USPSTF) issued lung cancer screening guidelines in 2013, uptake has been low. The USPSTF revised the guidelines in 2021 to expand eligibility. Purpose To determine whether patient-clinician discussions about lung cancer screening differs from 2017 to 2022 following 2021 revisions to the guidelines for lung cancer screening. Methods Data were obtained from the Health Information National Trends Survey (2017, 2020, and 2022). Community-dwelling US adults (N = 2973) were in the eligible age range for lung cancer screening (55-80 for 2017 and 2020; 50-80 for 2022), reported current or former smoking, and had no prior history of lung cancer. The primary outcome was self-reported patient-clinician discussions about lung cancer screening within the last 12 months. Results The weighted proportion of respondents who discussed lung cancer screening with a healthcare provider was 12.34% in 2017, 13.77% in 2020, and 9.42% in 2022. The odds of reporting screening discussions were significantly lower in 2022 than 2020 (OR = 0.58, 95% CI [0.36, 0.93]). Individuals with insurance (OR = 9.12, 95% CI [2.81, 29.96]) and those who were currently smoking (OR = 2.80, 95% CI [1.89, 4.13]) had higher odds of discussing screening. Conclusions Patient-clinician discussions about lung cancer screening were lower in 2022 than 2020, despite revised guidelines that broadened eligibility. Research should explore strategies to increase awareness of lung cancer screening and prioritize discussions about screening among those who are uninsured and formerly smoked.