Skip to main content
Journal cover image

Repeat Annual Lung Cancer Screening After Baseline Screening Among Screen-Negative Individuals: No-Cost Coverage Is Not Enough.

Publication ,  Journal Article
Tailor, TD; Bell, S; Doo, FX; Carlos, RC
Published in: J Am Coll Radiol
January 2023

PURPOSE: Adherence to lung cancer screening (LCS) is central to effective screening. The authors evaluated the likelihood of repeat annual LCS in a national commercially insured population and associations with individual characteristics, insurance characteristics, and annual out-of-pocket cost (OOPC) burden. METHODS: Using claims data from an employer-insured population (Clinformatics), individuals 55 to 80 years of age undergoing LCS between January 1, 2015, to September 30, 2019, with "negative" LCS were included. Repeat LCS was defined as low-dose chest CT occurring 10 to 15 months after the preceding LCS. Analysis was conducted over a 6-year period. Multivariable logistic regression was used to evaluate associations between repeat LCS and individual characteristics, insurance characteristics, and total OOPC incurred by the individual in the year of the index LCS, even if unrelated to LCS. RESULTS: Of 14,943 individuals with negative LCS, 4,561 (30.5%) underwent repeat LCS. Likelihood of repeat LCS was decreased for men (adjusted odds ratio [aOR], 0.91; 95% confidence interval [CI], 0.86-0.97), Hispanic ethnicity (aOR, 0.82; 95% CI, 0.69-0.97), and indemnity insurance plans (aOR, 0.36; 95% CI, 0.25-0.53). Relative to New England, individuals in nearly all US geographic regions were less likely to undergo repeat LCS. Finally, individuals with total OOPC in the highest two quartiles were less likely to undergo repeat LCS (aOR, 0.85 [95% CI, 0.77-0.92] for OOPC >$1,069.02-$2,475.09 vs $0-$351.82; aOR, 0.75 [95% CI, 0.68-0.82] for OOPC >$2,475.09 vs $0-$351.82). CONCLUSIONS: Although federal policies facilitate LCS without cost sharing, individuals incurring high OOPC, even when unrelated to LCS, are less likely to undergo repeat LCS. Future policy design should consider the permeative burden of OOPC across the health continuum on preventive services use.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Am Coll Radiol

DOI

EISSN

1558-349X

Publication Date

January 2023

Volume

20

Issue

1

Start / End Page

29 / 36

Location

United States

Related Subject Headings

  • Preventive Health Services
  • Odds Ratio
  • Nuclear Medicine & Medical Imaging
  • Mass Screening
  • Male
  • Lung Neoplasms
  • Humans
  • Early Detection of Cancer
  • 3202 Clinical sciences
  • 1117 Public Health and Health Services
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Tailor, T. D., Bell, S., Doo, F. X., & Carlos, R. C. (2023). Repeat Annual Lung Cancer Screening After Baseline Screening Among Screen-Negative Individuals: No-Cost Coverage Is Not Enough. J Am Coll Radiol, 20(1), 29–36. https://doi.org/10.1016/j.jacr.2022.11.005
Tailor, Tina D., Sarah Bell, Florence X. Doo, and Ruth C. Carlos. “Repeat Annual Lung Cancer Screening After Baseline Screening Among Screen-Negative Individuals: No-Cost Coverage Is Not Enough.J Am Coll Radiol 20, no. 1 (January 2023): 29–36. https://doi.org/10.1016/j.jacr.2022.11.005.
Tailor, Tina D., et al. “Repeat Annual Lung Cancer Screening After Baseline Screening Among Screen-Negative Individuals: No-Cost Coverage Is Not Enough.J Am Coll Radiol, vol. 20, no. 1, Jan. 2023, pp. 29–36. Pubmed, doi:10.1016/j.jacr.2022.11.005.
Journal cover image

Published In

J Am Coll Radiol

DOI

EISSN

1558-349X

Publication Date

January 2023

Volume

20

Issue

1

Start / End Page

29 / 36

Location

United States

Related Subject Headings

  • Preventive Health Services
  • Odds Ratio
  • Nuclear Medicine & Medical Imaging
  • Mass Screening
  • Male
  • Lung Neoplasms
  • Humans
  • Early Detection of Cancer
  • 3202 Clinical sciences
  • 1117 Public Health and Health Services