Diagnostic follow-up after positive lung cancer screening often falls short of guidelines, with only 60% of patients receiving guideline concordant follow-up after positive lung cancer screening.
A retrospective cohort study assessed diagnostic follow-up after positive low-dose computed tomography (LDCT) lung cancer screening results among Medicare beneficiaries. Researchers found that only about 60% of patients received guideline-concordant care, while nearly one-third had less intensive follow-up than recommended, according to a study published in Annals of Internal Medicine.
In fact, non-Hispanic Black, Asian, and Hispanic patients, current smokers, and those undergoing baseline screening were more likely to receive less intensive care the study says.
Researchers from the National Cancer Institute and colleagues analyzed linked data from the American College of Radiology Lung Cancer Screening Registry and Medicare claims for 64,555 adults aged 65 years or older with a first positive LDCT screening result between 2015 and 2021. Positive results were categorized using Lung-RADS scores (3, 4A, 4B, 4X).
Study Findings
- Overall, 59.7% of participants received guideline-concordant follow-up
- 32.3% received less intensive care, and
- 7.9% received more intensive care.
- Concordance increased with higher Lung-RADS scores.
- Within one year, 12.4% of participants were diagnosed with lung cancer, with rates rising alongside follow-up intensity.
- Invasive procedures were performed in 16.2% of participants overall and in 7.3% of those without lung cancer, including 0.8% who underwent lung resection.
“These findings highlight gaps in adherence to follow-up guidelines and persistent racial disparities, suggesting a need for targeted interventions to improve timely and appropriate care and improve lung cancer screening outcomes,” researchers say.
