A team of researchers led by epidemiology and biostatistics associate professor Dr. Jan Eberth (University of South Carolina, Arnold School of Public Health) has completed a study, published in Preventing Chronic Diseases, that assessed the availability of low-dose computed tomography (LDCT) for lung cancer screenings in the United States. In conjunction, they examined lung cancer mortality rates across geographic regions as well as the spatial proximity of high-risk populations to screening centers.
[Photo: Dr. Jan Eberth]
Although cancer death rates have decreased for lung, breast, prostate and colorectal cancers, lung cancer remains the leading cause of cancer-related death among U.S. men and women. Close to a quarter million people are diagnosed annually in the United States, with most diagnoses made at a late stage when the cancer is more difficult to treat.
Efforts to combat lung cancer have included the federally-sponsored National Lung Screening Trial, which demonstrated that screening high-risk populations (i.e., older adults with a smoking history) with LDCT each year can reduce lung cancer deaths by up to 20 percent. In 2013, the U.S. Preventive Services Task Force endorsed LDCT lung cancer screening for high-risk persons, which led to changes in reimbursement policies among insurers. The following year, amendments to coverage and billing codes were enacted by the Centers for Medicare & Medicaid Services.
Since these new recommendations were announced, researchers like Dr. Eberth have been working to determine whether and how much these changes have impacted patient and provider screening behaviors. For example, data from the 2015 National Health Interview Survey showed that just 4 percent of persons at high-risk for lung cancer had been screened in the last year.
In another 2015 study, Dr. Eberth and collaborators assessed family physicians’ knowledge of and attitudes toward LDCT lung cancer screening, concluding that these clinicians may have inaccurate knowledge about the new lung cancer screening recommendations. Dr. Eberth’s research on perceptions and practices of LDCT screening among physicians revealed that physicians identify LDCT as an appropriate tool for screening high-risk patients yet perceive a variety of barriers (e.g., prior authorization requirements, lack of insurance coverage, insurance denials) to engage in LDCT screening discussions with patients and making subsequent referrals.
“Our goal with this most recent study was to assess the landscape of LDCT screening in the United States,” says Dr. Eberth, who is also the director of the Rural and Minority Health Research Center. “We need to determine the availability of screening to identify regions for possible program expansion.”