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David S. Ettinger, MD, FACP, FCCP

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Newer USPSTF Guidelines: Are More Black Patients Being Screened for Lung Cancer?

By: Anna Fanelli
Posted: Wednesday, August 3, 2022

At the time the U.S. Preventive Services Task Force (USPSTF) published updated guidelines for annual lung cancer screening in 2021, many experts questioned whether the newer guidelines would increase the number of Black individuals being screened for lung cancer. However, a research letter published in JAMA Network Open shows that in fact it did—in the first 9 months after the updated guidelines took effect, there was an increase in the number of Black patients screened.

“While it is encouraging to see a larger cohort of African American patients getting screened thanks to the new guidelines, we are well aware that changing guidelines is only a first step to improving screening uptake and reducing cancer disparities,” said Julie Barta, MD, of Thomas Jefferson University, Philadelphia, and colleagues in a university press release.

The criteria published in 2013 defined those at high risk for lung cancer as people between the ages of 55 and 80 as well as those with at least a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. In 2021, the USPSTF recommendations were expanded to include those between the ages of 50 and 80 and lowered the pack-year history to 20.

In the recent research, the authors analyzed a cohort of 815 people who underwent lung cancer screening at the Center City campus of Jefferson Health. Patients were separated by those using the 2013 guidelines (a total of 654 patients) and those patients using the 2021 guidelines (a total of 161 patients). The authors reported that 54% of people eligible for screening by 2021 criteria were Black, whereas 39% were Black in the group that was eligible for screening using the 2013 criteria.

“Myriad challenges remain before individuals enter the door for screening,” commented Dr. Barta and colleagues. “Health policy changes must occur simultaneously with efforts to expand community outreach, overcome logistical barriers, and facilitate screening adherence.”

Disclosure: The study authors reported no conflicts of interest.


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