Background: Lung cancer is the leading cause of cancer death in U.S. men and women with just a 17.7% five-year survival rate. Based largely on the results of the National Lung Screening Trial, the U.S. Preventive Services Task Force recommends, and Medicare now covers, low-dose computed tomography for current and former smokers age 55 or older with at least 30 pack-year smoking history. While lung cancer incidence mortality rates are higher in men than women, this is in large part due differences in smoking status. Previous research shows that women worry about breast cancer to a greater extent than lung cancer, and there is a suggestion of greater lung cancer susceptibility in female smokers. We investigated whether there were gender differences in discussions with a doctor about lung cancer screening and awareness of a screening test for lung cancer.

Methods: Data are from the three cycles [4.2 (2013); 4.4(2015) and 5.1 (2017)] of the nationally representative Health Information National Trends Survey (HINTS). We included 4,658 respondents age 55 to 80 who responded to the following question: "In the past year, have you talked with your doctor about having a test to check for lung cancer?" and had available data on smoking status and gender. We assessed responses across survey cycles to see if the proportion responding "yes" to this question has increased over time, and whether this differed by gender. We used logistic regression accounting for complex sample weighting to generate adjusted odds ratios (AOR) and 95% confidence intervals (CI) for gender's association with discussion of lung cancer screening with a doctor in HINTS cycles 4.2, 4.4 and 5.1, and with awareness of lung cancer screening tests in cycle 4.4, accounting for potential confounders.

Results: Reported discussions with a doctor about lung cancer screening have not increased over time. In the most recent cycle, just 15.7% of current smokers (19.9% of males; 15.7% of females) and 9.9% of former smokers (12.4% of males; 6.9% of females) said they'd discussed screening. Compared to males, females were 32% less likely to report talking to their doctor about lung cancer screening (AOR: 0.68, 95% CI: 0.50-0.93). Estimates were similar among never (AOR: 0.72, 95% CI: 0.43-1.20), current (AOR: 0.73, 95% CI: 0.39-1.36), and former (AOR: 0.66, 95% CI: 0.40-1.10) smokers. Females were also 32% less likely to report that they'd heard of tests for early detection of lung cancer (OR: 0.68, 95% CI: 0.47-0.99) compared to males.

Conclusions: Though we are unable to assess pack-years of smoking, we found that irrespective of smoking status (never, current or former), women were less likely to have talked with their doctor about lung cancer screening and were less likely to be aware of lung cancer screening tests. Educational efforts may be needed to ensure that women receive the benefits of this important test.

Citation Format: Erica Warner, Christopher S. Lathan. Gender differences in awareness of lung cancer screening in the Health Information National Trends Survey, 2013-2017 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5277.