Lung Cancer Screenings Remained Stable in US Throughout the COVID-19 Pandemic, With Some States Seeing improvements

Lung cancer screenings in the United States remained stable during the COVID-19 pandemic, compared with screenings for other disease types, which declined significantly over the course of the outbreak, according to a study published in Chest.

Findings from the study found that lung cancer screenings remained consisten between 2019 (6.6%; 95% CI, 6.5%-7.4%) and 2020 (6.5%; 95% CI, 6.4%-7.3%; SRR, 0.99; 95% CI, 0.97-1.01).

“In this population-based study, [lung cancer screening] rates remained stable between 2019 and 2020 and just under 1 in 15 eligible people were screened. The lack of nationwide declines could be due to underutilization of [lung cancer screenings] before the pandemic began when only 5% to 6% of adults received screening in 2018, which limited the room for further decreases,” the investigators wrote.

The study used data from patients who were between the ages of 55 to 80 years old. Patients were also required to be current or former smokers who quit within the last 15 years or who have a 30 pack or greater per year history.

Previous studies have reported approximately 80% to 90% declines in screenings for breast, cervical, and colorectal cancer in March to April 2020, with rates rebounding in summer 2021 as lockdown restrictions eased.

In 2019 and 2020, 8.51 million adults were eligible for lung cancer screenings, of whom approximately 564,164 in 2019 and 557,795 in 2020 received screenings. Screenings drastically declined in 5 states between 2019 and 2020 by 23% to 52%, including Utah, Rhode Island, Vermont, Hawaii, and Maryland (SRR range, 0.77 to 0.48).

However, investigators reported that between 2019 and 2020, SRRs had not changed in 25 states and increased in 19 states by 20% or more (SRRs ≥1.2), including Nevada, West Virginia, Maine, and Kentucky.

Investigators believe that the increases in testing could imply that health systems and both local and state cancer control efforts were effective in improving testing rates. Additionally, states that had lower screening rates may have had stricter stay-at-home orders due to the COVID-19 pandemic.

“There were 5 states in which [lung cancer screening] rates statistically significantly decreased, including Hawaii and Utah, which had below-average rates before the pandemic began. For example, orders were more comprehensive and enduring in the Northeast, but there was a mix of [lung cancer screening] patterns within this region, with annual [lung cancer screening] rates unchanged in New York, which is a state that experienced a substantial surge of COVID-19 infection during the Spring of 2020 but declined in Vermont” the investigators concluded.

Reference

Fedewa SA, Bandi P, Smith RA, Silvestri GA, Jemal A. Lung cancer screening rates during the COVID-19 pandemic. Chest. Published online July 21, 2021. doi:10.1016/j.chest.2021.07.030