A new study of lung cancer screening participants finds that low-dose chest computed tomography (CT) tests are generally well tolerated physically and mentally, but experiences vary by socio-economic group. Low-income groups and safety net participants faced greater test-related burdens and increased discomfort and anxiety due to factors such as insurance and employment status. The survey results are: Journal of the American College of Radiologya paper published by Elsevier, highlights opportunities to improve fairness in review.
Lung cancer is the leading cause of cancer death in the United States, and early detection of lung cancer saves lives. In the real world, participation rates and long-term adherence to lung cancer screening with low-dose CT remain low.
Most studies have focused on clinical outcomes and less on how patients actually experience the screening test itself. We investigated whether patients experience short-term effects, such as discomfort and anxiety, associated with lung cancer screening, particularly in underserved populations with high barriers to treatment. ”
Jessica H. Polembka, MD, Principal Investigator, Department of Radiology, University of Texas Southwestern Medical Center
Researchers conducted a prospective study of 468 lung cancer screening participants from both a university health system and a county safety-net system (serving low-income and marginalized communities) to assess the physical and emotional impact of screening using validated patient-reported scales. Although the overall test-related burden was very low, some patients reported discomfort and anxiety.
Safety net participants reported pain and discomfort more frequently before and during screening. In multivariate analysis, marital status, employment, and insurance status were associated with testing-related burden.
Dr. Polembka points out, “Lung cancer screening saves lives, but it only works if patients come back every year. Even a small, temporary burden from screening can affect whether they return for their annual exam, which is a key component of screening effectiveness.”
Research findings point to opportunities for targeted interventions, including:
- Reduce pre-exam anxiety
- Improving the physical exam experience
- Addressing structural barriers in underserved environments
This study is one of the first to quantify the impact of lung cancer screening using a validated instrument and explore how the healthcare environment and social determinants of health influence patient experience. Understanding these factors is essential to improving both adherence and equity in lung cancer screening.
Co-researcher and editor-in-chief Journal of the American College of Radiology Ruth Carlos, MD, MS, of the Department of Radiology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, concluded, “We are relieved to see that the overall testing burden is low, suggesting that testing itself is not a major barrier for most patients. At the same time, it is noteworthy that differences in patient experience are closely related to social and economic factors, highlighting the importance of a more patient-centered and equity-oriented approach.” screening. ”
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Reference magazines:
Polembuka, J.H.; Others. (2026). Low-dose chest CT examination burden among patient-reported lung cancer screening participants. Journal of the American College of Radiology. DOI: 10.1016/j.jacr.2026.05.017. https://www.jacr.org/article/S1546-1440(26)00280-2/fulltext
