A retrospective cohort examined 3,507 low-dose CT lung screening examinations requiring further evaluation in a community programme in Japan between 2010 and 2025. Within 365 days, 678 examinations (19.3%) had no documented diagnostic follow-up, and current smoking carried an adjusted odds ratio of 2.15 (95% CI 1.71-2.70) for nonattendance against former smoking, as well as slower attendance among those who did come. Respiratory symptoms were associated with lower odds of nonattendance, while the suspected disease category was not associated with it at all.
Why it is interesting: The group at highest lung cancer risk is the least likely to complete the pathway a screen opens, which bears on how much of a trial's mortality benefit a real programme keeps.