# Bridging Mammography and Lung Cancer Screening: Eligibility, Uptake and Potential Impact

## TL;DR

Many women eligible for lung cancer screening also get mammograms, suggesting integrating these screenings could help detect lung cancer earlier, especially in rural areas.

## Contribution

The study identifies a potential strategy to improve lung cancer detection by leveraging existing mammography programs.

## Key findings

- 45.2% of women with lung cancer were eligible for both mammography and lung cancer screening.
- Mammography uptake was significantly higher than lung cancer screening uptake among dually eligible women.
- Rural residency was associated with lower lung cancer screening uptake, while receiving mammography was linked to higher uptake.

## Abstract

Lung cancer (LC) is the top cancer killer in women, yet lung cancer screening (LCS) uptake is substantially lower than mammography. Leveraging the reach of mammography programs may improve LCS uptake, but the potential gain in LC detection from this approach is unknown. This study aimed to determine the proportion of women with LC eligible for both screenings, potential LC detection via integrated screening, and factors influencing each screening uptake among those dually eligible.

This retrospective cross‐sectional study included 345 women newly diagnosed with LC presenting at a Midwestern Comprehensive Cancer Center (2019–2020). Pre‐diagnosis LCS‐eligibility was determined per 2013 and 2021 USPSTF criteria, LCS‐uptake per 2013 criteria, and mammography‐eligibility per 2016 criteria. We assessed sociodemographic variables associated with screening uptake among dually eligible women.

Among 345 women (mean [SD] age 64.8 [11.35] years), 73.3% were eligible for mammography, while 43.5% were eligible for LCS (2013), increasing to 49.3% (2021). Mammography uptake (41.5%) substantially exceeded LCS uptake (13.9%). Overall, 45.2% were eligible for both screenings, representing 92.4% (157/170) of all LCS‐eligible (2021) cases. Notably, 20.3% were LCS‐eligible (2021) and received mammography, that is, 41.2% (70/170) of LCS‐eligible cases. Among dually eligible women, rural residency correlated with lower LCS uptake (odds ratio [OR], 0.42; 95% CI = 0.19–0.94; p = 0.031), whereas receiving mammography correlated with higher LCS uptake (OR, 2.67; 95% CI = 1.21–5.87; p = 0.013).

A substantial proportion of women with LC who are LCS‐eligible underwent mammography, representing a missed opportunity for earlier LC detection. Integrating these screenings could enhance LC detection, especially for rural residents who experience disparities in LCS but not mammography uptake.