European Journal of Molecular & Clinical Medicine

Abstract

Lung cancer is the leading cause of cancer death for men and women in the United States, accounting for 24% of all cancer deaths. Early detection is essential since survival is based on the stage of diagnosis: 59.8% of patients survive for 5 years while the disease is localized, but only 6.3% do so when it has spread to other organs. Unfortunately, only 18% of lung cancer cases are found early on, while 56% are found after cancer has spread to other body parts. The National Lung Screening Trial compared annual low-dose computed tomography (LDCT) screening for lung cancer with chest radiograph (CXR) screening in 2002; in 2011, they observed a 20% reduction in lung cancer mortality and a 6.7% reduction in total mortality.^1,2 In March 2013, the U.S. Preventive Services Task Force (USPSTF) published a grade B recommendation for annual LDCT screening in asymptomatic patients aged 55 to 80 with a 30-pack-year smoking history who are presently smoking or have quit smoking within 15 years, supported by this and another research. To fund preventive services under the Medicare program that met specific requirements, the Centers for Medicare and Medicaid Services introduced LDCT screening in February 2015. The age cutoff was lowered to 50, and the pack-year exposure to 20 in the USPSTF guideline, amended in March 2021.LDCT is highly effective but underutilized. Although LDCT screening has been known for more than ten years to reduce lung cancer mortality and has been advised for more than six years, utilization is still unacceptably low, with 19.2% of those eligible obtaining the test in 2018. Compared to colonoscopies, mammograms, and Papanicolaou testing, screening rates for other frequent cancer screenings are substantially higher, at about 80%, 70%, and 60%, respectively. The lesser use of LDCT relative to other cancer screening tests is due to several factors. Physicians might not be aware of the mortality benefit of LDCT screening. Both issues are false-positive results and following-up nodules in a healthcare system that does not support the practice. It's common to point to the expense of LDCT screening and the cumbersome insurance authorization procedures as barriers, particularly for people without insurance