USPSTF Lung Cancer Screening Too Conservative for Blacks

Current U.S. Preventive Services Task Force (USPSTF) guidelines for lung cancer screening eligibility may be too conservative for African American smokers, according to a study published online June 27 in JAMA Oncology.

Melinda C. Aldrich, Ph.D., from Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues examined the diagnostic accuracy of USPSTF lung cancer screening eligibility criteria. A total of 48,364 ever smokers were enrolled, of whom 67 percent were African American and 33 percent were white.

A total of 1,269 incident lung cancers were identified among the participants. The researchers found that 17 percent of African American smokers and 31 percent of white smokers were eligible for USPSTF screening. Among those diagnosed with lung cancer, 32 percent of African Americans and 56 percent of white smokers were eligible for screening. The lower percentage of African American smokers eligible for screening was mainly associated with fewer smoking pack-years among African American versus white smokers (median pack-years, 25.8 versus 48, respectively). For all ages, there was racial disparity in the sensitivity and specificity of USPSTF guidelines between African American and white smokers. Lowering the smoking pack-year eligibility criteria to a minimum 20 pack-year history would increase screening eligibility for African American smokers.

"Our results support revision of the USPSTF lung cancer screening guidelines to reduce the required number of smoking pack-years for African American smokers if simple eligibility criteria are maintained," the authors write.

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