A new study from Kaiser Permanente Oakland Medical Center suggests that a routine mammogram could be a good moment to catch women who qualify for lung cancer screening but have never had it.
What the researchers found
The study, titled "Missed by a Pack," appears in the Annals of Thoracic Surgery Short Reports. Researchers compared patient surveys with electronic health record data for 1,299 women getting screening mammograms at Kaiser's Oakland clinic. The surveys identified 19 women who met U.S. Preventive Services Task Force criteria for lung cancer screening. Of those, 37% had no documented screening counseling or low-dose CT scan, according to the Kaiser Permanente Bernard J. Tyson School of Medicine.
Why smoking history matters
Lung screening eligibility depends almost entirely on smoking history measured in "pack-years," and records don't capture it reliably. "Smoking history is dynamic: people start, stop, and change how much they smoke throughout their lives," said first author Elaine Liang, a student at the medical school. The study found that providers' general chart notes matched what patients reported more closely than the structured smoking section of the health record, which often lacked the detail needed to calculate lifetime exposure.
Why mammograms
The women getting mammograms largely overlap in age with those eligible for lung screening, and the school notes that lung cancer remains the leading cause of cancer death among women. Senior author Dr. Jeffrey Velotta said the work gives the health system a chance to use the high volume of mammograms "to improve our lung cancer screening uptake simultaneously." Asking a few extra questions at check-in doesn't require a separate appointment.
If you're unsure whether you qualify for lung cancer screening, ask your doctor. Eligibility is based on age and smoking history.