The Effect of Smoking Status and Race on Lung Cancer Screening Uptake

Man smoking, cigarette
Man smoking, cigarette
Former smokers may be more likely to complete lung cancer screening.

This article is part of Pulmonology Advisor‘s coverage of the CHEST 2019 meeting, taking place in New Orleans, LA. Our staff will report on medical research related to asthma, COPD, critical care medicine, and more conducted by experts in the field. Check back regularly for more news from CHEST 2019.

NEW ORLEANS ­­— Although former smokers may be more likely to complete lung cancer screening in a racially diverse group of patients, smoking status may not be significantly associated with completing a screening among black patients vs white patients, according to an abstract presented at the CHEST Annual Meeting 2019, held from October 19-23, 2019, in New Orleans, Louisiana.

In 2013, the US Preventive Services Task Force recommended lung cancer screenings by low-dose computed tomography (LDCT) for patients aged 55 to 80 years with a smoking history of ≥30 pack-years. Researchers aimed to assess factors that may affect uptake of screening recommendations, specifically, race and smoking status at the time of the first screening, using a multivariable logistic regression.

A total of 4097 electronic medical records of patients referred for lung cancer screening between March 1, 2015, and February 28, 2018, were evaluated. Of all referred patients, 932 (22.7%) were black and 2747 (67.0%) were white. Of all patients, 60.7% were smokers; 57.3% were white smokers and 70.2% were black smokers. Overall, 2791 (68.1%) patients had completed an initial LDCT screen: 614 (22.0%) were black and 1902 (68.1%) were white.

Results of the multivariable analyses demonstrated that race itself was not associated with completion of LDCT screening, and former smokers were more likely to complete the LDCT screening than current smokers (adjusted odds ratio, 1.17, 95% CI 1.01-1.36). However, among whites, the adjusted odds ratio for lung cancer screening uptake comparing former with current smokers was 1.32 (95% CI, 1.10-1.59), and among blacks, smoking status was not significantly associated with screening (adjusted odds ratio, 0.84; 95% CI, 0.60-1.16).

Related Articles

“Racially diverse patient groups may require tailored shared decision making in lung cancer screening,” the researchers concluded.

Visit Pulmonology Advisor‘s conference section for continuous coverage from CHEST 2019.


Neslund-Dudas C, Alleman E, Tang A, et al. Impact of current smoking status on uptake of lung cancer screening referral in a cohort of racially diverse patients. Presented at: CHEST Annual Meeting 2019; October 19-23, 2019; New Orleans, LA. Abstract 321.