Fewer than one in five eligible adults get screened for lung cancer, with gaps in patient awareness, doctor discussions, and insurance coverage slowing uptake.
RT’s Three Key Takeaways:
- Low Screening Rates: Only about 18% of eligible US adults underwent lung cancer screening in 2022, lagging far behind rates for breast and colorectal cancer screenings, according to a cross-sectional synthesis of national surveillance data.
- Communication Gaps: Surveillance data revealed that 73% of eligible adults had never discussed lung cancer risk with a clinician, and only 38% were aware that screening was available for high-risk individuals.
- Healthcare Access Barriers: Screening participation dropped to 4% among uninsured adults and 5% among those without a primary care provider, demonstrating the critical impact of healthcare access on screening utilization.
Low-dose computed tomography lung cancer screening reduces mortality among high-risk individuals, yet national adoption remains persistently low despite more than a decade of guideline support, according to data from a cross-sectional analysis presented at Chest 2026.
To assess national uptake deficits and evaluate barriers across the screening pathway, investigators analyzed publicly reported 2022 US national surveillance datasets. Screening eligibility was established using US Preventive Services Task Force (USPSTF) guidelines, which recommend annual screening for adults aged 50 to 80 years with at least a 20 pack-year smoking history who currently smoke or have quit within the past 15 years.
Screening Lags Behind Other Cancers
According to published 2022 estimates, LCS uptake among eligible US adults reached approximately 18%. By comparison, surveillance data showed that screening uptake was approximately 77% for breast cancer and 61% for colorectal cancer.
The analysis identified widespread deficits in patient education and clinical engagement. National surveys indicated that only 38% of adults knew that LCS was available for high-risk individuals, while 73% had never discussed their lung cancer risk with a healthcare clinician, according to the research findings.
Access Disparities Hinder Utilization
The findings also underscored substantial disparities associated with insurance status and access to care. According to the study data, screening uptake was roughly 4% among eligible uninsured individuals, compared with 14% among individuals with private insurance, and 26% among those covered by Medicare.
Linkage to outpatient clinical care also played a decisive role in whether eligible candidates received scans. Researchers reported that only about 5% of eligible adults without a primary care provider underwent screening, compared with 19% of adults who maintained an established primary care relationship.
“Efforts to improve LCS uptake should prioritize routine identification of eligible patients within primary care, consistent clinician-led risk communication and shared decisionmaking, and reduction of access barriers related to insurance coverage and primary care linkage,” said Sarvesh Sharma, MD, CHEST 2026 presenting author, in a news release. “Addressing these structural bottlenecks is likely necessary for translating the demonstrated efficacy of LCS into population-level mortality reduction.”
Researchers concluded that addressing awareness deficits, clinician-patient communication gaps, and healthcare access barriers is essential to expanding screening utilization among eligible populations and achieving broader mortality reduction.
