What factors influence low follow-up adherence after a positive LDCT cancer screening?

Experts are calling for strategies to improve follow-up adherence among individuals who have positive lung cancer screenings after a new analysis revealed low rates of compliance. 

Centered on 685 individuals with LDCT scans that yielded concerning results, the study found that in some cases follow-up adherence during a specified timeframe was as low as 30%.  

Several factors were associated with low compliance, all of which were highlighted recently in JAMA, where experts involved in the research suggested that there is a need for tailored interventions among specific populations to increase follow-up follow through. 

“Individuals found to have a nodule on LDCT have a higher likelihood of lung cancer; therefore, it is crucial to ensure appropriate follow-up occurs in this group,” corresponding author M. Patricia Rivera, MD, of University of Rochester Medical Center and colleagues wrote. 

The researchers found that subpar follow-up adherence was more common among current smokers, Black and male individuals and those with Lung-RADS category 3 nodules. However, when suspicion for malignancy was higher, follow-up compliance improved. The same trend was noted when patients were given an extended follow-up timeline—the consequences of which remain unclear. 

“Although an extended, more liberal timeline for follow-up of a positive LDCT improves adherence rates, the impact of delays in follow-up care of screen-detected nodules is not well-known,” the authors wrote. 

They went on to explain that while delaying follow-up care among low-risk nodules likely would not impact outcomes, there is not enough evidence to appropriately define the potential implications. 

Specifically, the authors recommended that efforts should focus on better defining recommended follow-up timelines for certain high-risk nodules (Lung-RADs 4B and 4X). They also indicated that there is a greater need for understanding the root of lower adherence rates in Black individuals, men and current smokers. 

Learn more about the data here.

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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.

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