Increased Disparities in Patients Diagnosed with Metastatic Lung Cancer Following Lung CT Screening in the United States

The Surveillance, Epidemiology, and End Result (SEER) database was utilized to assess the impact of CT screening on lung cancer stage distribution from 2009-2018. The percentage of patients diagnosed with metastatic disease decreased overall, but there were no significant changes for black patients. These results associate CT screening to changes in lung cancer stage distribution, but potential racial disparities exist. Objectives: We sought to determine if implementation of low dose computed tomography (LDCT) screening for lung cancer in the United States had led to changes in patients being diagnosed with metastatic lung cancer over time.Materials and Methods: The Surveillance, Epidemiology, and End Result (SEER) database was utilized to determine the proportion of lung cancers diagnosed as stage Ito Ill and stage IV from 2009-2018. Changes in lung cancer stage distribution were compared in the overall population and by race. Results: From 2009 to 2018, the proportion of stage Ito Ill lung cancers increased from 52% (51.3%-53.2%) in 2009 to 56% (54.0%-55.8%) in 2018 (P < .001). Correspondingly, the proportion of lung cancers diagnosed in stage IV decreased from 48% (46.8%-48.7%) in 2009 to 45% (44.2%-46.0%) (P < .001) in 2018. For white patients, the proportion increased from 53% (51.6%-53.7%) to 56% (55.1%-57.1%) (P < .001). However, for black patients, no trend was present, with the proportion being 51% (47.9%53.4%) in 2009 and 52% (49.0%-54.2%) in 2018 (P = .303). Conclusion: Since the implementation of LDCT screening, the proportion of early-stage lung cancers increased in the general population. These changes in stage distribution were not present in black patients. (C) 2021 Elsevier Inc. All rights reserved.

Automated summary

The impact of CT screening on lung cancer stage distribution was evaluated using the SEER database from 2009-2018. Overall, there was a decrease in the percentage of patients diagnosed with metastatic disease, but no significant changes were observed for black patients. These findings suggest a link between CT screening and changes in lung cancer stage distribution, with potential racial disparities.