VA Lung Cancer Screening Recovered More Than Two Years After Pandemic Disruption

Researchers compared lung cancer screening, CT use, diagnosis rates and cancer size at diagnosis before and during the COVID-19 pandemic among users of the Veterans Affairs (VA) health system. The analysis included 1,867,387 Veterans eligible for lung cancer screening and compared January 2017–February 2020 with March 2020–June 2023.

Among eligible Veterans, annual screening fell from 7.3% in January 2020 to 5.7%, then recovered to pre-pandemic rates by March 2022. The reported rate reached 11% by June 2023. Among eligible Veterans who did not participate in screening, median cancer size at diagnosis decreased from 20 mm (95% CI, 19–20) to 18 mm (95% CI, 16–19) after the pandemic began. Screened Veterans had smaller tumors at diagnosis (median 15 mm), with no reported pandemic-related change. Lung cancer diagnosis rates among VA users were lower than expected based on pre-pandemic data.

The findings indicate a prolonged disruption in screening and lower-than-expected diagnoses, but do not establish that the pandemic caused these changes or demonstrate effects on mortality. Results are specific to the VA population; the supplied report does not provide further detail on methods or subgroup estimates.