57 Lung cancer screening can save lives by detecting the disease at an earlier stage, but only 15% of eligible American adults have discussed screening with their doctors, according to a data analysis by researchers at the University of Cincinnati Cancer Center. Senior author Robert Van Haren, MD, said the findings, recently published in the American Journal of Surgery, highlight the need to raise public awareness and improve education about screening with low-dose Computed Tomography (CT) scans, a type of X-ray imaging that uses less radiation than a standard CT scan. Van Haren and colleagues analysed data from the most recent Health Information National Trends Survey (HINTS), conducted by the National Cancer Institute and designed to provide a representative sample of people across the US. “They ask a lot of questions about Americans’ health, their behaviours around health, like diet, exercise, smoking, alcohol, and about healthy behaviours, including screenings for lung, breast and colon cancer,” said Van Haren. “There’s a lot of information, and it gives you a general picture of what American society thinks about healthcare, healthy behaviours and patients’ communication with physicians.” Van Haren noted that the 15% figure represents an increase compared with the previous set of HINTS data. “It is slowly improving, which is good, but it’s still very, very low when you compare it to other screening rates, like colonoscopy or mammograms, that are usually in the 70%–80% range of people getting screened,” he said. The need to raise awareness is particularly acute in the Greater Cincinnati area, where 9 of the 10 counties primarily served by the Cancer Center have higher smoking rates than the national average. Approximately 1 in 3 adults in the region smoke, twice the national average. Van Haren said lung cancer screening is probably the easiest of the three most common cancer screening tests. “Patients lie down and go through the CT scan device and quickly hold their breath, and we take some pictures of the lungs to make sure they’re healthy,” he said. “There’s no IV, no prep. It’s completely noninvasive and very fast and easy.” The US Preventive Services Task Force recommends lung cancer screening with low-dose CT scans for adults aged 50–80 who have a 20 pack-year smoking history and currently smoke, or who have quit within the past 15 years. A pack-year is calculated by multiplying the number of packs of cigarettes smoked per day by the number of years smoked. One pack-year is equivalent to smoking one pack a day for one year, or two packs a day for six months. A 20 pack-year history would mean smoking one pack a day for 20 years. Funded by a Cancer Center pilot grant, Van Haren’s team is interviewing primary care doctors and patients in the community to identify the barriers and other factors preventing these potentially lifesaving conversations. The researchers hypothesise that stigma and fear surrounding lung cancer, along with the relatively new screening method, may be among the contributing factors. “Low dose CT screening is relatively new in the last 15 years, and we haven’t done a great job of getting the message out that it’s here,” Van Haren said. “It saves lives by detecting cancer early where we can treat it very successfully.” In the long term, Van Haren said he hopes to see more community and regional partnerships, alongside a focused awareness campaign, to encourage more conversations between patients and doctors, leading to more screenings and, ultimately, more lives saved.