Researchers Examine Barriers to Low-Dose CT Lung Cancer Screening

In the U.S., over half of all lung cancer patients already have metastatic disease by the time they are diagnosed, according to the National Cancer Institute.


For those patients, the prognosis shows a five-year survival rate of only 4.7 percent. By contrast, patients who present with localized disease have a five-year survival rate of 56 percent.

Screening for lung cancer can help reduce mortality by detecting cancers at earlier stages when they are more treatable. The landmark National Lung Screening Trial (NLST) was undertaken to compare the efficacy of lung cancer screening (LCS) with low-dose CT versus chest radiography. In 2011, NLST investigators reported that for current and former high-risk smokers, three rounds of annual screening using low-dose CT reduced lung cancer mortality by 20 percent.

Based on the strength of the NLST results, LCS with low-dose CT received a favorable recommendation from the U.S. Preventive Services Task Force in 2011 and has been a covered service without co-payment for nearly all eligible current and former smokers by public and private payors since 2015. However, according to research presented at the 2018 American Society of Clinical Oncology Annual Meeting, only 1.9 percent of over 7 million current and former high-risk smokers underwent screening in 2016.

In a recent Radiology review, “Barriers to Lung Cancer Screening Engagement from the Patient and Provider Perspective,” lead author Gary X. Wang, MD, fourth-year radiology resident at Massachusetts General Hospital (MGH), Boston, and senior author Efren J. Flores, MD, officer of radiology community health improvement and equity at MGH, and colleagues discussed the obstacles confronting patients and primary care physicians (PCPs) as they consider LCS with low-dose CT.

To read about the patient and primary care physician barriers to LCS, review the study. Raises Awareness of Lung Cancer Screening

Lack of patient awareness is a barrier to lung cancer screening (LCS). Radiologists can help educate their patients by directing them to, the RSNA/ACR public information website featuring easy-to-understand descriptions of over 245 procedures, exams and disease topics.

Patients will find questions to these lung cancer questions:

  • What is lung cancer?
  • How is lung cancer diagnosed and evaluated?
  • How is lung cancer treated? also features printable handouts on 155 procedure descriptions.