A MULTICENTRE cohort study found that adherence to annual lung cancer screening declines over time, with lower adherence linked to reduced lung cancer detection rates.
The study analysed data from 10,170 adults aged 55–75 years who were current or former smokers and underwent baseline LCS between 2015–2018. Conducted across five USA healthcare systems, the study examined adherence to follow-up screening at years one (T1) and two (T2) after baseline. Adherence was defined as undergoing chest CT within specific time frames based on baseline screening results. Participants with missing data or prior lung cancer diagnoses were excluded. Data analysis was carried out from October 2023–October 2024.
Among eligible participants, 61.2% (95% CI: 60.2–62.2%) adhered to annual screening at T1, dropping to 50.5% (95% CI: 49.5–51.4%) at T2. Those adherent at T1 were significantly more likely to remain adherent at T2 (adjusted relative risk: 2.40; 95% CI: 2.06–2.79). Over the 36-month follow-up, 2.7% (95% CI: 2.4–3.1%) of participants were diagnosed with lung cancer. Incident lung cancer rates were highest in the first year (1.3%; 95% CI: 1.1–1.6%) and declined in subsequent years (0.7% in T1 and 0.8% in T2). However, screening adherence was associated with higher lung cancer detection rates in both T1 (1.0% vs 0.2%, P<0.001) and T2 (1.3% vs 0.2%, P<0.001). Furthermore, early-stage lung cancers were more frequently diagnosed among adherent individuals at T2 (73.0% vs 25.0%, P=0.006).
These findings reinforce the importance of LCS adherence in improving lung cancer detection rates, particularly at early stages. However, the decline in adherence over time highlights the need for targeted interventions to enhance long-term screening participation.
Ada Enesco, EMJ
Reference
Kim RY et al. Adherence to annual lung cancer screening and rates of cancer diagnosis. JAMA Netw Open. 2025;8(3):e250942.
