Likelihood of Lung Cancer Screening by Poor Health Status and Race and Ethnicity in US Adults, 2017 to 2020

Abstract

Lung cancer is the leading cause of cancer deaths in the US.¹ From 2013 to 2021, the US Preventive Services Task Force recommended lung cancer screening (LCS) via low-dose computed tomography for adults aged 55 to 80 years with a greater than 30 pack-year history who are current smokers or quit within 15 years.² The US Preventive Services Task Force additionally highlights the need to screen only those willing and able to undergo lung surgery,^2,3 and all national guidelines recommend against screening those with poor baseline health status, whether quantified as less than 10 years’ life expectancy (American College of Chest Physicians),⁴ “life limiting comorbid conditions” (American Cancer Society),⁵ or “as long as patient functional status and comorbidity allow consideration for curative intent therapy” (National Comprehensive Cancer Network).⁶ Although national guidelines are consistent in recommending that baseline health should be considered prior to screening, how to define poor health is unclear, and the American Thoracic Society recognizes that there is an urgent need for more research in this area.⁷