Who is eligible for lung cancer screening, and where are they? National subpopulation estimates of people eligible for lung cancer screening

BACKGROUND: The utilization of lung cancer screening services is less than 20%. There are a myriad of barriers at the patient, provider, and health care system levels that account for such low uptake. One reason lung cancer screening rates remain low is that identifying who is eligible is challenging at the patient and at the population level because a quantitative estimate of smoking history (i.e., 20 pack-years of cigarette smoking exposure) is required to determine eligibility. This pack-year determination is often missing from clinical documentation and is also absent in large health survey data. METHODS: The Smoking History Generator was integrated into national cross-sectional surveys to estimate smoking exposure intensity and duration for older US adults who have smoked. National estimates, at the substate level, for the number of individuals eligible for lung cancer screening are presented. RESULTS: A publicly available dataset that enables researchers to estimate the population eligible for lung cancer screening at the census tract level was developed. Additionally, this approach permits exploration and description of the eligible population by age, sex, racial/ethnic groups, and current or former smoking status. CONCLUSION: The dataset can be aggregated by geographic location (e.g., county, state) and filtered by age range, sex, race/ethnicity, and smoking status to estimate specific subpopulations eligible for lung cancer screening. This dataset will greatly enhance future programmatic efforts to identify and direct resources to individuals eligible for lung cancer screening.