ATS Releases Statement on Lung Cancer Screening Disparities

The American Thoracic Society has released a scientific statement addressing disparities in lung cancer screening (LCS) eligibility and focusing on barriers to screening and strategies to improve screening rates among at-risk groups.

The statement was created by a multidisciplinary group of experts in LCS, implementation science, primary care, pulmonology, health behavior, smoking cessation, epidemiology, and disparity research.

Among the major disparities in LCS:

  • The 2013 USPSTF LCS guidelines neglect to consider racial, ethnic, socioeconomic, and sex-based differences in smoking behavior and lung cancer risk.
  • Rural individuals who smoke and are at high risk for lung cancer have less geographic availability of LCS.
  • Variability in insurance coverage for LCS marginalizes vulnerable populations.

Among the proposed strategies:

  • Providers should use multipronged approaches to address multilevel barriers to LCS and reduce disparities.
  • Healthcare institutions should create quality metrics for the evaluation of equity in LCS.
  • Evidence on the benefits and harms of LCS in various diverse populations should be created.
  • Tobacco treatment programs should be developed that address differences in language, cultural beliefs, and literacy.
  • Providers and institutions should support the expansion of Medicaid coverage for LCS in all states.

“Addressing inequities in LCS is important not only for social justice and fundamental human rights but also for the improvement of the overall health of the U.S. population and for the reduction of healthcare costs. Because LCS is a fairly new preventive service, quality metrics and ongoing research will be needed across the spectrum of dissemination and implementation to ensure that interventions minimize disparity gaps and positively impact health outcomes in all patients,” they concluded.

—Michael Potts


Rivera MP, Katki HA, Tanner NT, et al. Addressing disparities in lung cancer screening eligibility and healthcare access. an official American Thoracic Society statement. Am J Respir Crit Care Med. 2020;202(7):e95-e112. doi: 10.1164/rccm.202008-3053ST.