Lung Cancer Screening Eligibility and Screening Patterns Among Black and White Adults in the United States

Jessica W Lozier,Gerard A Silvestri,Stacey A Fedewa,Robert A Smith

doi:10.1001/jamanetworkopen.2021.30350

Jessica W Lozier, Gerard A Silvestri + Show 2 more

Open Access

https://doi.org/10.1001/jamanetworkopen.2021.30350

Copy DOI

Abstract

This cohort study compares the demographics of US adults who are currently being screened for lung cancer and assesses the potential association between proposed changes to the United States Preventive Services Task Force (USPSTF) screening recommendations and screening rates by race and age.

Highlights

Lung cancer screening (LCS) with annual low radiation dose computed tomography (LDCT) for adults aged 55 years to 80 years with a 30 pack-year history of smoking was initially recommended by the United States Preventive Services Task Force (USPSTF) in 2013
The main outcome was the proportion of respondents who were eligible for LCS according to USPSTF criteria and self-reported receipt of LDCT in the past year according to race and ethnicity
Race was considered in this study because of the disparities in lung cancer mortality between Black and White people and the new USPSTF guidelines were aimed at reducing these disparities

Summary

Introduction

Lung cancer screening (LCS) with annual low radiation dose computed tomography (LDCT) for adults aged 55 years to 80 years with a 30 pack-year history of smoking was initially recommended by the United States Preventive Services Task Force (USPSTF) in 2013. In 2020, a large European trial demonstrated a mortality benefit from screening in persons aged 50 years with a 20 pack-year history of smoking.[1] Based on these results and predictive modeling, the USPSTF recently updated their recommendations by lowering the age and pack-year requirements for screening from 55 years to 50 years and 30 pack-years to 20 pack-years, respectively.[2]. Black individuals tend to develop lung cancer at a younger age with less pack-year history of smoking and have worse outcomes than White individuals.[3] lowering the age and pack-year requirements will increase the number of Black persons eligible for LCS. We undertook this study to compare the demographics of US adults who are currently being screened for lung cancer to assess how the proposed changes might influence screening rates by race and age going forward

Methods

Results

Conclusion