Estimating Lung Cancer Screening Utilization in the US Using the 2023 Behavioral Risk Factor Surveillance System Data
Author(s)
Naomi Q.P. Tan, PhD1, Kristin G. Maki, PhD2;
1Rutgers University, Rutgers Cancer Institute,, New Brunswick, NJ, USA, 2Wayne State University School of Medicine, Assistant Professor, Royal OK, MI, USA
1Rutgers University, Rutgers Cancer Institute,, New Brunswick, NJ, USA, 2Wayne State University School of Medicine, Assistant Professor, Royal OK, MI, USA
Presentation Documents
OBJECTIVES: Lung cancer screening (LCS) can reduce mortality, but utilization in the United States (US) remains low. Reports from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) data showed 16.4-18.1% of people eligible for LCS were screened. It is crucial to monitor trends in LCS due to the recently changed eligibility criteria that were aimed at reducing disparities among racial minorities and females. Our objectives are: 1) to report on the prevalence of LCS in the US using the 2023 BRFSS data, and 2) examine differences between subgroups.
METHODS: We used the 2023 BRFSS data from 6 states that used the optional LCS module (California, Maine, New Jersey, Georgia, Kansas, and Maryland). We included individuals eligible for LCS (aged 50-79, 20 pack-year smoking history, currently smoke or quit within 15 years) and excluded respondents previously diagnosed with lung cancer. We calculated the percentage and 95% confidence intervals of eligible respondents who reported receiving a CT scan for LCS and conducted multivariable logistic regression to assess sociodemographic associations with LCS completion. We used the “survey” package in RStudio.
RESULTS: There were 932,746 respondents who were eligible for LCS and 17.7% (n=164,942) completed screening within the past 12 months. Screening rates differed by state (range=15.1-30.8%) and by race and ethnicity (White: 21.0%; Asian: 8.8%; Black 22.4%: Hispanic: 9.8%). Logistic regression showed a higher likelihood of completing LCS among respondents that have a regular health professional compared to those who do not (OR=17.5, 95%CI: 2.1-144.5); and among respondents reporting fair (OR=3.6, 95%CI: 1.2-11.0) and poor (OR=3.7, 95%CI: 1.2-11.5) health compared to excellent health.
CONCLUSIONS: LCS uptake has continued to improve slightly from previous years. However, uptake remains low and disparities across states and race and ethnicity persist. Being more engaged in healthcare, whether due to poor health or having a regular provider, may help facilitate LCS uptake.
METHODS: We used the 2023 BRFSS data from 6 states that used the optional LCS module (California, Maine, New Jersey, Georgia, Kansas, and Maryland). We included individuals eligible for LCS (aged 50-79, 20 pack-year smoking history, currently smoke or quit within 15 years) and excluded respondents previously diagnosed with lung cancer. We calculated the percentage and 95% confidence intervals of eligible respondents who reported receiving a CT scan for LCS and conducted multivariable logistic regression to assess sociodemographic associations with LCS completion. We used the “survey” package in RStudio.
RESULTS: There were 932,746 respondents who were eligible for LCS and 17.7% (n=164,942) completed screening within the past 12 months. Screening rates differed by state (range=15.1-30.8%) and by race and ethnicity (White: 21.0%; Asian: 8.8%; Black 22.4%: Hispanic: 9.8%). Logistic regression showed a higher likelihood of completing LCS among respondents that have a regular health professional compared to those who do not (OR=17.5, 95%CI: 2.1-144.5); and among respondents reporting fair (OR=3.6, 95%CI: 1.2-11.0) and poor (OR=3.7, 95%CI: 1.2-11.5) health compared to excellent health.
CONCLUSIONS: LCS uptake has continued to improve slightly from previous years. However, uptake remains low and disparities across states and race and ethnicity persist. Being more engaged in healthcare, whether due to poor health or having a regular provider, may help facilitate LCS uptake.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH18
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology