Although lung cancer screening (LCS) with low-dose computed tomography (LDCT) is currently recommended for those who fulfill standard risk factor-based eligibility criteria, the impact of comorbidity on LCS with LDCT uptake in an older real-world U.S. population remains unknown. A study aimed to determine the links between comorbidity, functional status, and LCS use in the United States. Researchers examined the association of comorbid conditions and functional limitations regarding activities of daily living with LCS utilization among participants who met the LCS criteria based on the US Preventive Service Taskforce guidelines using population-based data from the 2017–2019 Behavioral Risk Factor Surveillance System. They used multivariable weighted logistic regression models to investigate these overall correlations within subgroups defined by age (<65 yr vs. ⩾65 yr), sex, and smoking habits.

The 1,731 (16%) of the 11,214 participants who met the LCS eligibility requirements underwent LCS with LDCT. The bulk of the participants were White (90%), male (55%), former smokers (52%), and had at least one chronic comorbid condition (77%). More than 28% of those surveyed had 3 or more comorbid diseases, and over 40% of those surveyed said they had functional restrictions. In multivariable models, having had LCS with LDCT within the previous year was associated with more comorbidity  ⩾5 vs. 0: adjusted odds ratio, 2.34; 95% confidence interval [CI], 1.22–4.48) but not with functional limitations  (⩾3 vs. 0: adjusted odds ratio, 1.00; 95% CI, 0.66–1.50). A higher chance of LCS with LDCT is associated with comorbid diseases. Future study is essential to identify the health status of LCS-eligible persons, as poor health status may reduce the benefits of screening.