Women who are at high risk for lung cancer based on smoking history are less likely than men to have discussions with their doctors about potentially life-saving early detection screening, a new study has found.
In a 2017 survey, women were 32% less likely to report having a lung cancer screening discussion with a provider than men were, and the association was strongest among non-Hispanic white females. The study also found that women were 32% less likely than males to know testing was available for early detection of lung cancer.
“Too few health care providers have discussed lung cancer screening with potentially eligible patients, particularly female patients, and increased communication could improve screening rates,” say authors of a report in the July issue of Preventive Medicine.
Christopher Lathan, MD, MPH, of Dana-Farber’s department of Medical Oncology is an author on the publication. First author is Erica T. Warner, ScD, MPH, of the department of Medicine at Massachusetts General Hospital.
In 2011, the National Lung Screening Trial demonstrated a 20% reduction in mortality associated with annual screening using low-dose computed tomography scans. It is estimated that 12,000 lives could be saved annually in the United States if all individuals eligible for lung cancer screening received it.
In 2013, the United States Preventive Services task force recommended annual screening among current and former smokers (who quit within the last 15 years) ages 55 to 80 with at least a 30-pack-year smoking history.
Nevertheless, lung cancer screening rates are low, with only an estimated 5.8% of eligible high-risk smokers screened in 2015. The current study found that the proportion of patients discussing screening had not increased between 2013 and 2017.
The researchers investigated differences in discussions with physicians about lung cancer screening and awareness using data from 2013, 2014, and 2017 in the Health Information National Trends Survey. The study included 4,207 individuals ages 55 to 80 who answered the question, “In the past year, have you talked with your doctor about having a test to check for lung cancer?”
In the most recent cycle, 15.7% of current smokers and 9.9% of former smokers said they had discussed screening. Females were less likely to report a lung cancer screening discussion and to be aware of a lung cancer screening test. This latter disparity — awareness of the availability of a screening test — was strongest among non-Hispanic Black females.
“While educational and other interventions are needed for all patients, our study identifies specific groups that could benefit from focused attention, and this is especially important given recent evidence that women may receive even greater mortality benefit from lung cancer screening than men,” the authors say.