WCLC 2025 - Posters & ePosters-P1.04.05 Diminishing Eligibility for Lung Cancer Screening According to Standardized Screening Guidelines

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This study analyzed lung cancer screening eligibility trends among patients diagnosed with lung cancer within Kaiser Permanente Northern California from 2014 to 2022, using linked electronic health records and cancer registry data. The United States Preventive Services Task Force (USPSTF) updated lung cancer screening guidelines in 2021, expanding eligibility to individuals aged 50-80 with at least 20 pack-years of smoking history who have smoked within the past 15 years. Despite this, the study found that a shrinking proportion of lung cancer patients actually meet these screening criteria over time.<br /><br />Among 11,738 lung cancer cases, only 23.5% met the USPSTF screening eligibility. The proportion eligible decreased by 8.8% overall from 2014-2016 to 2020-2022. This decline was most pronounced in non-Hispanic Black patients (12.4% decrease) and those diagnosed with stage I disease (13.1% decrease). Eligibility also declined across age groups, sex, and neighborhood deprivation indices, indicating a broad trend regardless of demographic or socioeconomic factors.<br /><br />Key demographic findings showed eligible patients were younger on average, more likely to be non-Hispanic White, female, and have a history of smoking. Notably, many patients with lung cancer do not meet current screening criteria, creating a growing gap between recommended screening populations and the actual lung cancer patient population.<br /><br />The study underscores the need to develop more inclusive and equitable lung cancer screening strategies beyond the current USPSTF guidelines. Future research should focus on identifying alternative methods to select at-risk individuals, accounting for disparities in race, smoking history, and socioeconomic status to improve early detection and reduce lung cancer mortality. This highlights a critical public health challenge as current screening eligibility fails to capture a substantial proportion of individuals who ultimately develop lung cancer.

Asset Subtitle

Janet Song

Meta Tag

Speaker Janet Song

Topic Screening and Early Detection

Keywords

lung cancer screening

USPSTF guidelines

screening eligibility trends

Kaiser Permanente Northern California

electronic health records

cancer registry data

racial disparities in screening

smoking history

early lung cancer detection

health equity