Lung cancer screening guidelines miss the mark in African-Americans

  • Aldrich MC & al.
  • JAMA Oncol
  • 27 Jun 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Significantly fewer African-American smokers with lung cancer met the US Preventive Services Task Force (USPSTF) recommendations for lung cancer screening compared with white smokers.

Why this matters

  • Lowering the USPSTF minimum pack-year requirement to 20 years and the minimum age of lung cancer diagnosis to age 50 years for African Americans would lead to more equitable screening.

Study design

  • 48,364 ever-smokers (67% African American; 33% white) from the Southern Community Cohort Study.
  • Funding: NIH.

Key results

  • Among people diagnosed with lung cancer, more African-Americans were ineligible for low-dose computed tomography (LDCT) screening than whites (67.8% vs 43.5%; P<.001>
  • African-Americans with lung cancer were less likely than whites with lung cancer to meet the minimum 30-pack-year screening requirement (66.8% vs 37.0%; P<.001 and were more likely to be ineligible because they diagnosed with lung cancer before the uspstf-required minimum age of years vs p=".046).</li">
  • White former smokers with lung cancer were more likely than African-Americans with lung cancer to be ineligible for screening because of quit times >15 years compared with black smokers (21% vs 9%; P<.001>

Limitations

  • Self-reported smoking history.