Opportunities for lung cancer screening: A prospective cross-sectional study of patients with lung cancer treated at an academic cancer center.

Abstract

e22528 Background: In 2021, the U.S. Preventive Services Task Force (USPSTF) expanded criteria for lung cancer screening (LCS) with annual low-dose CT (LDCT) for adults aged 50-80 years with ≥20 pack-years (PY) who currently smoke or quit within 15 years. We examined implementation of LCS among patients with lung cancer treated at our center prior to their cancer diagnosis. Methods: Cross-sectional questionnaire survey of patients with lung cancer and ever-smoking history, treated at our institution was conducted between June 2022 and June 2024. Demographics, cancer stage, smoking history, cessation timing, primary care physician (PCP) engagement, LCS with modality were captured. Eligibility for USPSTF 2021 LCS specifically a year preceding cancer diagnosis was assessed for each patient. Responses that allowed direct verification or reasonable inference for eligibility were analyzed. Results: Cross-sectional questionnaire survey of patients with lung cancer and ever-smoking history, treated at our institution was conducted between June 2022 and June 2024. Demographics, cancer stage, smoking history, cessation timing, primary care physician (PCP) engagement, LCS with modality were captured. Eligibility for USPSTF 2021 LCS specifically a year preceding cancer diagnosis was assessed for each patient. Responses that allowed direct verification or reasonable inference for eligibility were analyzed. Conclusions: Our study supports published data on under-utilization of LDCT and provides a peek into the real-world implications of this gap by demonstrating that > 60% of patients in this cohort were diagnosed at an advanced stage, which could perhaps have been prevented if LCS was performed years prior. This data highlights the magnitude of missed opportunities for early lung cancer detection. The percentage of patients lacking a PCP could also have been a barrier for optimal LCS. Our findings highlight the urgent need to enhance patient and clinician awareness of guidelines and improve referral pathways. Summary of patients included in the analysis. Metric Value Total respondents 244 Respondents with analyzable eligibility/number eligible 131/110 Age (years) Mean 69.8; Median 72 Gender (%) Male: 56; Female: 44 Age at first tobacco use (years) Median 16 (IQR 15.0-18.5) Stage III-IV at diagnosis 79 (60.3%) Tobacco use at time of survey 35 (26.7%) Median cessation period for those who quit (years) 2 (IQR 1-6) PY Mean 53.5; Median 47.0