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Showing content from http://www.ncbi.nlm.nih.gov/pubmed/31019776 below:

Trends in lung cancer screening in the United States, 2016-2017

. 2019 Mar;11(3):873-881. doi: 10.21037/jtd.2019.01.105. Trends in lung cancer screening in the United States, 2016-2017

Affiliations

¹ Division of Cardiothoracic Surgery, University of Texas Medical Branch, Galveston, TX, USA.
² Division of Pulmonary, Critical Care and Sleep Medicine, University of Texas Medical Branch, Galveston, TX, USA.
³ Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.
⁴ Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA.

PMID: 31019776
PMCID: PMC6462682
DOI: 10.21037/jtd.2019.01.105

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Trends in lung cancer screening in the United States, 2016-2017

Ikenna C Okereke et al. J Thorac Dis. 2019 Mar.

. 2019 Mar;11(3):873-881. doi: 10.21037/jtd.2019.01.105. Affiliations

¹ Division of Cardiothoracic Surgery, University of Texas Medical Branch, Galveston, TX, USA.
² Division of Pulmonary, Critical Care and Sleep Medicine, University of Texas Medical Branch, Galveston, TX, USA.
³ Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.
⁴ Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA.

PMID: 31019776
PMCID: PMC6462682
DOI: 10.21037/jtd.2019.01.105

Item in Clipboard

Abstract

Background: Lung cancer is the most common cancer killer annually, yet the overall rate of eligible patients who undergo screening with low-dose computed tomography (LDCT) is low. Our goal was to determine factors which were associated with the probability of obtaining lung cancer screening.

Methods: The Clinformatics Data Mart (CDM) database, a national commercial health insurance database with over 18,000,000 enrollees, was queried to determine the rate of LDCT screening and factors which influenced receiving LDCT screening. All enrollees between the ages of 55 and 77 from 2016 to 2017 were included. Demographics, history of tobacco exposure and state smoking statistics were recorded.

Results: All 8,350,197 enrollees aged 55-77 were included in the study. Among enrollees, the rate of screening increased throughout 2016 and early 2017 and then appeared to stabilize. In the second half of 2017 the LDCT rate was approximately 6 per 1,000 enrollees per year, and was increasing at a slope of 0.1 additional LDCT per 1,000 enrollees per year. There was marked geographic variation, with 5-fold differences in LDCT rates between different regions. There was no correlation between smoking rate and LDCT rate at the state level (r=0.02; P=0.87). Enrollees aged 65-69 were most likely to be screened (OR =1.53; 1.45-1.61) compared to enrollees aged 55-59.

Conclusions: The rate of LDCT screening is increasing very slowly with time, and most eligible patients are not screened. Further studies are needed to determine the reasons for low screening rates, and the marked geographic variation.

Keywords: Early detection of cancer; lung neoplasms; tobacco smoking.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures
Figure 1

Number of enrollees aged 55–77…

Figure 1

Number of enrollees aged 55–77 receiving LDCT screening, per 1,000 enrollees, per month,…

Figure 1

Number of enrollees aged 55–77 receiving LDCT screening, per 1,000 enrollees, per month, in 2016 and 2017. The arrows indicate a significant (P<0.01) change in slope of the increase in LDCT rate. After May 2017, the rate of increase was close to 0, at 0.1 additional enrollee with LDCT per 1000 enrollees per year. LDCT, low-dose computed tomography.

Figure 2

Map showing percentage of enrollees…

Figure 2

Map showing percentage of enrollees aged 55–77 who underwent LDCT scan screening in…

Figure 2

Map showing percentage of enrollees aged 55–77 who underwent LDCT scan screening in 2017, by state. States are color-coded by quintile of LDCT rate. LDCT, low-dose computed tomography.

Figure 3

Scatter plot for number of…

Figure 3

Scatter plot for number of enrollees aged 55–77, per thousand, undergoing LDCT screening…

Figure 3

Scatter plot for number of enrollees aged 55–77, per thousand, undergoing LDCT screening in 2017 vs. number of current daily smokers per 1,000 among residents aged 55–79 in 2016. BRFSS data were used to estimate daily smoking rate. The correlation between the LDCT and smoking rates was r=0.02, P=0.87. LDCT, low-dose computed tomography.

Figure S1

Cohort selection using Clinformatics ^TM…

Figure S1

Cohort selection using Clinformatics ^TM Data Mart in 2016 and 2017.

Figure S1

Cohort selection using Clinformatics^TM Data Mart in 2016 and 2017.