Lung cancer screening using low-dose CT: The current national landscape

•Just over 200 U.S. institutions now offer low-dose CT (LDCT) lung cancer screening.•Most LDCT screening centers are located in the Northeast and East North Central states, where lung cancer incidence and mortality are high.•Several states with high lung cancer burden and smoking prevalence had no screening centers.•The average number of centers per state was 4, or 0.3 centers per 100,000 persons aged 55–79.

ObjectivesAlthough the National Lung Screening Trial (NLST) lauds the efficacy of low-dose computed tomography (LDCT) at reducing lung cancer mortality, it has not been widely used for population-based screening. By examining the availability of U.S. LDCT screening centers, and underlying rates of lung cancer incidence, mortality, and smoking prevalence, the need for additional centers may be determined.Materials and methodsLocations of 203 LDCT screening centers from the Lung Cancer Alliance Screening Centers of Excellence database, a list of active NLST and International Early Lung and Cardiac Action Program (I-ELCAP) screening centers, and an independently conducted survey of Society of Thoracic Radiology members were geocoded and mapped. County-level rates of lung cancer incidence, mortality, and smoking prevalence were also mapped and overlaid with the locations of the 203 LDCT screening centers.Results and conclusionsResults showed the majority of LDCT screening centers were located in the counties with the highest quartiles of lung cancer incidence and mortality in the Northeast and East North Central states, but several high-risk states had no or few identified screening centers including Oklahoma, Nevada, Mississippi, and Arkansas. As guidelines are implemented and reimbursement for LDCT screening follows, equitable access to LDCT screening centers will become increasingly important, particularly in regions with high rates of lung cancer incidence and smoking prevalence.