A new study suggests that modifying current lung cancer screening guidelines could significantly reduce racial disparities in screening eligibility, potentially leading to earlier detection and improved outcomes for Black Americans. The research, published in the Journal of Clinical Oncology, challenges the current U.S. Preventative Services Task Force (USPSTF) recommendation that uses pack-year smoking history as a criterion for screening eligibility.
Researchers from Mass General Cancer Center and Boston University, proposes replacing the 20-pack-year requirement with a 20-year smoking duration requirement. This change could increase the proportion of lung cancer patients who would qualify for screening and eliminate the racial disparity in eligibility between Black and white individuals.
Dr. Chi-Fu Yang, co-senior author of the study, stated, “Our findings challenge the use of pack-year smoking history in determining lung cancer screening eligibility and support the use of smoking duration cutoffs, instead, as a simple yet effective change to increase the sensitivity of the guideline and improve equity in opportunities for screening.”
The researchers analyzed data from two large cohort studies and found that under the current USPSTF guideline, only 57.6% of Black patients with lung cancer would have qualified for screening, compared to 74.0% of white patients. With the proposed change, these percentages increased to 85.3% and 82.0%, respectively.
Dr. Julie Palmer, another co-senior author, emphasized the importance of improving access to lung cancer screening for Black Americans, who experience disproportionately high lung cancer mortality rates. The researchers hope their findings will encourage the USPSTF to reconsider the use of pack-year smoking history in determining screening eligibility, potentially leading to more equitable preventive care recommendations.
See “Proposed lung cancer screening guideline could eliminate racial disparities, allow for early detection” (August 5, 2024)