Predictors and Uptake of Lung Cancer Screening in the US: An Integrative Literature Review

Abstract

Early detection of lung cancer with low-dose computed tomography decreases lung cancer mortality significantly, yet lung cancer screening (LCS) rates in the US remain low. This integrative review estimates LCS prevalence, identifies barriers, and highlights future research needs. A medical librarian searched PubMed, CINAHL, OVID Medline, and OVID Embase for quantitative US-based studies published between 2014-2023. A dual review of the abstracts of all articles was conducted by the authors (SS, LM, EC, HP) to determine the eligible articles based on the pre-determined inclusion/ exclusion criteria. After applying the inclusion criteria, 38 studies were analyzed. Findings indicate that LCS remains underutilized, with majority of studies reporting uptake rates below 30%. Disparities in LCS use were notable among racial and ethnic minoritized adults, uninsured individuals, and residents of specific regions. These results underscore the need for further research into disparities in LCS utilization and adherence. Future researchers should focus more on the factors that may cause LCS disparities, such as organizational-level policies, LCS access, and LCS decision-making resources, to improve LCS uptake throughout the country.

Keywords: Low-dose Computed Tomography; Lung Cancer; Lung Cancer Screening.