Lung cancer screening among Medicaid older adults in New Jersey, 2017-2022.

Abstract

Routine lung cancer screenings (LCS) were disrupted during the COVID-19 pandemic. The study objective is to describe LCS trends longitudinally and by sociodemographic characteristics among New Jersey Medicaid enrollees aged 55-75 years who were potentially LCS-eligible from 2017 to 2022. This descriptive analysis used 2017-2022 New Jersey Medicaid claims data. The analytical sample included 317,763 enrollees aged 55-75 who were potentially LCS-eligible. LCS eligibility was identified using claims-based indicators of smoking history and status. Rates were stratified by age, sex, race-ethnicity, Medicaid dual eligibility status, and geographic region. Pearson's chi-squared tests assessed within-group differences. LCS rates were lowest in April 2020 (3.45 per 1000 LCS-eligible enrollees). By August 2020, rates rebounded to pre-pandemic levels (15.53 per 1000), peaking in November 2022 (35.22 per 1000). The younger group (55-64 years old) consistently had higher rates than the older (65-75). Rates for non-Hispanic Black enrollees showed the largest change among racial-ethnic groups (16.0 per 1000 in 2019; 52.9 per 1000 in 2022). This study suggests that rates rebounded due to increased public attention to lung health, broadening of LCS eligibility guidelines, and statewide screening initiatives. Future research should examine which factors drove the changes and whether changes sustained.