TABLE 1.
Estimated number of individuals eligible for lung cancer screening with USPSTF 2013 and 2021 recommendations
| USPSTF 2013 | USPSTF 2021 | % Relative increase | |||
|---|---|---|---|---|---|
| n (%) | 95% CI | n (%) | 95% CI | ||
| Estimated number eligible for LCS | 7,855,300 (100%) | 7,277,312–8,433,288 | 14,247,383 (100%) | 13,461,620–15,033,146 | 81.4 |
| Sex | |||||
| Male | 4,516,657 (57.5%) | 4,063,799–4,969,515 | 7,895,284 (55.4%) | 7,292,622–8,497,946 | 74.8 |
| Female | 3,338,643 (42.5%) | 2,963,848–3,713,438 | 6,352,099 (44.6%) | 5,836,622–6,867,576 | 90.3 |
| Race and ethnicity | |||||
| Hispanic | 277,418 (3.5%) | 182,658–372,178 | 591,030 (4.1%) | 452,522–729,538 | 113.0 |
| Non‐Hispanic White | 6,833,710 (87.0%) | 6,298,882–7,368,538 | 12,158,729 (83.7%) | 11,415,700–12,901,758 | 77.9 |
| Non‐Hispanic Black | 538,271 (6.9%) | 428,394–648,148 | 1,116,653 (7.7%) | 951,111–1,282,195 | 107.5 |
| Non‐Hispanic Asian | 157,408 (2.0%) | 67,400–247,416 | 538,271 (3.7%) | 153,027–366,523 | 242.0 |
| All other race and ethnic groups | 48,493 (0.6%) | 13,821–83,165 | 121,196 (0.8%) | 56,803–185,589 | 149.9 |
| Educational attainment | |||||
| Less than high school diploma/GED | 1,572,707 (20.0%) | 1,283,351–1,862,063 | 2,711,036 (19.1%) | 2,331,751–3,090,321 | 72.4 |
| High school diploma and above | 6,272,003 (80.0%) | 5,743,668–6,800,338 | 11,509,652 (80.9%) | 10,809,045–12,210,259 | 83.5 |
| Region | |||||
| Northeast | 1,188,421 (18.1%) | 925,393–1,451,450 | 2,457,151 (17.2%) | 2,046,295–2,868,007 | 106.8 |
| Midwest | 2,080,986 (29.7%) | 1,783,397–2,378,575 | 3,740,965 (26.3%) | 3,383,181–4,098,749 | 79.8 |
| South | 3,207,448 (44.4%) | 2,849,760–3,565,136 | 5,664,008 (39.8%) | 5,165,340–6,162,676 | 76.6 |
| West | 1,378,445 (20.1%) | 1,164,599–1,592,291 | 2,385,259 (16.7%) | 2,118,957–2,651,561 | 73.0 |
| Income to poverty ratio | |||||
| ≥1 (i.e., above poverty level) | 4,591,780 (87.6%) | 4,136,471–5,047,089 | 7,943,944 (84.0%) | 7,332,187–8,555,701 | 73.0 |
| <1 (i.e., poverty level or below) | 822,549 (18.0%) | 665,434–979,664 | 1,513,357 (16.0%) | 1,281,157–1,745,557 | 84.0 |
| Employment history | |||||
| Work currently or in past 12 months | 3,084,412 (39.3%) | 2,704,228–2,704,228 | 6,424,077 (45.1%) | 5,877,936–6,970,218 | 108.3 |
| Have not worked in past 12 months | 4,768,591 (60.7%) | 4,333,778–5,203,404 | 7,814,826 (54.9%) | 7,221,070–8,408,582 | 63.9 |
| Health insurance status | |||||
| Insured | 7,346,100 (93.6%) | 6,778,725–7,913,476 | 13,177,495 (92.6%) | 12,412,458–13,942,532 | 79.4 |
| Uninsured | 499,857 (6.4%) | 359,017–640,697 | 1,052,394 (7.4%) | 842,148–1,262,640 | 110.5 |
| Health insurance subcategories (individuals <65 years) | |||||
| Private | 2,572,038 (57.6%) | 2,216,304–2,927,773 | 5,395,081 (57.1%) | 4,876,217–5,913,945 | 109.8 |
| Medicaid and other public | 693,051 (15.5%) | 513,212–872,890 | 1,715,428 (18.2%) | 1,405,381–2,025,475 | 147.5 |
| Other coverage | 711,954 (15.9%) | 536,100–887,809 | 1,297,275 (13.7%) | 1,035,368–1,559,182 | 82.2 |
| No insurance | 488,384 (10.9%) | 348,423–628,345 | 1,038,976 (11.0%) | 829,487–1,248,465 | 112.7 |
| Health insurance subcategories (individuals 65+ years) | |||||
| Private | 1,276,843 (32.9%) | 1,032,761–1,520,925 | 1,864,919 (33.7%) | 1,559,561–2,170,277 | 46.1 |
| Dual eligible | 301,475 (8.9%) | 177,983–424,967 | 417,182 (8.7%) | 276,166–558,198 | 38.4 |
| Medicare only | 1,410,068 (24.1%) | 1,185,566–1,634,570 | 1,956,333 (23.4%) | 1,704,083–2,208,583 | 38.7 |
| Other coverage | 375,496 (22.6%) | 261,788–489,204 | 526,102 (22.9%) | 397,173–655,031 | 40.1 |
| Uninsured | 11,473 (11.1%) | −4235–27,181 | 13,418 (11.0%) | −2592–29,428 | 17.0 |
| Use of preventive care | |||||
| Does not get preventive care | 539,298 (49.5%) | 367,722–710,874 | 1,025,215 (49.3%) | 813,331–1,237,099 | 90.1 |
| Clinic or health center | 134,094 (12.3%) | 59,889–208,299 | 229,752 (11.0%) | 132,939–326,565 | 71.3 |
| Doctor's office or HMO | 243,494 (22.4%) | 121,906–365,082 | 530,547 (25.5%) | 361,377–699,717 | 117.9 |
| Hospital emergency room | 6927 (0.6%) | −3188–17,042 | 39,132 (1.9%) | 405–77,859 | 464.9 |
| Hospital outpatient | 13,856 (1.3%) | −4380–32,092 | 28,088 (1.4%) | −1871–58,047 | 102.7 |
| Some other place | 28,333 (2.6%) | −3935–60,601 | 59,929 (2.9%) | 12,665–107,193 | 111.5 |
| Does not go to one place most often | 123,446 (11.3%) | 50,814–196,078 | 167,288 (8.0%) | 86,412–248,164 | 35.5 |
| Reasons for delaying medical care in the past 12 months | |||||
| Could not get through on phone (Yes) | 221,232 (2.8%) | 123,238–319,226 | 430,459 (3.0%) | 284,849–576,069 | 94.6 |
| Could not get through on phone (No) | 7,616,591 (97.2%) | 7,041,330–8,191,852 | 13,780,929 (97.0%) | 12,993,818–14,568,040 | 80.9 |
| Could not get appointment soon enough (Yes) | 518,591 (6.6%) | 378,942–658,241 | 1,001,343 (7.0%) | 791,033–1,211,653 | 93.1 |
| Could not get appointment soon enough (No) | 7,319,232 (93.4%) | 6,772,201–7,866,263 | 13,206,395 (93.0%) | 12,449,759–13,963,031 | 80.4 |
| Wait too long in doctor's office (Yes) | 374,537 (4.8%) | 252,663–496,411 | 763,318 (5.4%) | 594,333–932,303 | 103.8 |
| Wait too long in doctor's office (No) | 7,463,286 (95.2%) | 6,895,205–8,031,367 | 13,448,070 (94.6%) | 12,676,526–14,219,614 | 80.2 |
| Not open when you could go (Yes) | 108,990 (1.4%) | 48,964–169,016 | 390,387 (2.7%) | 249,867–530,907 | 258.2 |
| Not open when you could go (No) | 7,728,833 (98.6%) | 7,156,118–8,301,548 | 13,820,287 (97.3%) | 13,050,750–14,589,824 | 78.8 |
| No transportation (Yes) | 286,416 (3.7%) | 151,571–421,261 | 637,027 (4.5%) | 449,169–824,886 | 122.4 |
| No transportation (No) | 7,551,407 (96.3%) | 6,978,651–8,124,163 | 13,573,647 (95.5%) | 12,797,613–14,349,681 | 79.7 |
Abbreviations: CI, confidence interval; LCS, lung cancer screening; USPSTF, U.S. Preventive Services Task Force.