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A new population-based study show that although national lung cancer screening (LCS) rates decreased in some states, overall LCS rates remained low and unchanged, and 19 states experienced significant improvements in screening rates despite the COVID-19 pandemic. In five states (Utah, Rhode Island, Vermont, Hawaii, and Maryland), LCS significantly decreased by 23-52%, including some with lower LCS rates before the pandemic.

This study, led by Stacey Fedewa, PhD, American Cancer Society, examined annual LCS rates before (2019) and during (2020) the COVID-19 pandemic nationally and by state. The report, appearing in the journal, CHEST, shows that nationally LCS rates remained stable between 2019 and 2020, and just under 1 in 15 eligible persons were screened. Among 8.51 million eligible adults, only 564,164 and 557,795 adults received LCS in 2019 and 2020, respectively. Data indicate that the lack of nationwide declines could be due to underutilization of LCS before the pandemic began where only 5-6% of adults received screening in 2018, limiting the room for further decreases. Furthermore, states’ stay-at-home orders and COVID-19 surges may have influenced short-term screening volumes, though there was not a clear pattern with annual LCS rates. During the same period, screening rates were unchanged in 25 states.

Screening rates, however, increased between 2019 and 2020 for 19 states, suggesting that health systems and local and state-level cancer control efforts played a role in improving LCS. For example, Kentucky, which has one of the nation’s highest LCS rates, has made concerted efforts to improve LCS since 2013.Lung cancer remains the leading cause of cancer death in the United States and annual LCS with low dose computed tomography (LDCT) is recommended for a group that is at a high-risk of dying from this disease.

“This is just one of the many research studies informing on cancer care during the pandemic,” write the authors. “Best practices from successful state and local LCS programs could inform ongoing efforts to detect lung cancers early.”

Article: Fedewa SA, Bandi P, Smith RA, Silvestri GA, Jemal A. Lung Cancer Screening Rates During the COVID-19 Pandemic. CHEST. doi: 10.1016/j.chest.2021.07.030.