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New Guidelines Upped Lung Cancer Screenings, But Gaps Remain
- March 24, 2025
- Dennis Thompson HealthDay Reporter
More smokers are getting CT screenings for lung cancer, thanks to guideline changes that included younger people and those who’ve smoked less, a new study says.
However, significant gaps remain for these potentially life-saving scans, particularly among people with limited access to health care, researchers reported March 20 in JAMA Oncology.
“The updated guidelines substantially increased lung cancer screenings overall, even as cancer screenings declined during the COVID-19 pandemic," Tracy Crane, an associate professor of oncology at the University of Miami Miller School of Medicine, said in a news release.
"However, discrepancies for who is screened persist, underscoring the importance of addressing structural barriers in rural and underserved populations,” she added.
Lung cancer remains the leading cause of cancer death in the U.S. for both men and women, researchers said in background notes.
Since 2013, guidelines have recommended using low-dose CT chest scans to screen for lung cancer in older heavy smokers.
But those guidelines were updated in 2021 to start screening at 50 instead of 55, and to include those with a smoking history of 20 or more pack-years instead of 30 or more, researchers noted.
Pack-years are calculated by multiplying the number of years a person smoked by the number of packs they smoked each day.
To see whether these guideline changes brought in more patients, researchers analyzed data from more than 17,000 Americans who participated in a federal survey tracking U.S. health behaviors between 2019 and 2023.
Before the guideline change, only about 15% of people at high risk for lung cancer were up-to-date on their CT screenings, researchers found.
But a year after the guidelines were updated, the percentage jumped to 47% of those eligible for CT screening, results showed.
That’s better, but still less than half, researchers said. The numbers were lower in people without insurance, those without a primary care doctor and those in rural areas.
Lung cancer screenings require a referral, creating a barrier for people without a family doctor, researchers noted.
People who don’t get regular health care also might not be aware they’re eligible for such screening, researchers added.
CT screening can also be too pricey for people without insurance. Without coverage, a scan can cost hundreds of dollars, lead researcher LaShae Rolle, a doctoral research fellow at the University of Miami, noted in a news release.
People can access free or low-cost scans, “but screening is not a one-time deal. Patients should get a scan annually, and results may require additional testing," researcher Dr. Coral Olazagasti, an assistant professor of clinical medical oncology, said in a news release. "The costs come not only from the scan but the follow-up.”
Community outreach teams might be able to close these gaps, along with patient navigators who can help educate people and line up their screenings, researchers said.
"A person may say -- I don't have the money; I don't have insurance. But, no one thinks they have cancer," Rolle said. "I am a cancer survivor myself. I was diagnosed at 26. I understand how easy it is to brush off a screening, especially among those choosing between having food or getting screened.”
Rolle caught her breast cancer early and is now cancer-free.
"I would love for others to get screened so they can also catch cancer early, too," she said.
More information
The U.S. Centers for Disease Control and Prevention has more on screening for lung cancer.
SOURCE: University of Miami, news release, March 20, 2025
