Race and sex differences in patient provider communication and awareness of lung cancer screening in the health information National Trends Survey, 2013–2017

Abstract

Despite demonstrated reduction in lung cancer mortality, lung cancer screening uptake has been low. We investigated differences in discussions with physicians about lung cancer screening and awareness using repeated cross-sectional data from three cycles [4.2 (2013); 4.4(2014) and 5.1 (2017)] of the Health Information National Trends Survey. We included 4207 respondents age 55 to 80 who responded to this question: ‘In the past year, have you talked with your doctor about having a test to check for lung cancer?’. We used logistic regression accounting for complex sample weighting to generate multivariable adjusted odds ratios (ORs) and 95% confidence intervals (CIs). The proportion of participants reporting lung cancer screening discussions was low and did not increase over time. In the most recent cycle, 15.7% of current smokers and 9.9% of former smokers said they had discussed screening. Compared to males, females were 32% less likely to report a lung cancer screening discussion (OR: 0.68, 95% CI: 0.50–0.93) and the association was strongest among non-Hispanic White females. Estimates were similar among never (OR: 0.72, 95% CI: 0.43–1.20), current (OR: 0.73, 95% CI: 0.39–1.36), and former (OR: 0.66, 95% CI: 0.40–1.10) smokers. Females were 32% less likely than males to be aware of a lung cancer screening test (OR: 0.68, 95% CI: 0.47–0.99) and this association was strongest for non-Hispanic Black females (OR: 0.38, 95% CI: 0.19–0.77). Too few providers have discussed lung cancer screening with potentially eligible patients, particularly female patients. Further research is needed to evaluate possible causes for this finding.