Are Lung Cancer Screening Guidelines Adequate for High-Risk Minorities?
Posted: Friday, August 17, 2018
Developed in 2011, the national lung cancer screening guidelines, which are based on age and smoking history, may not be sufficient for individuals in underrepresented communications, according to data from a lung cancer screening program at the University of Illinois at Chicago (UIC). The investigators suggest that these guidelines be examined more closely to determine whether additional risk factors—such as a history of chronic pulmonary disease, having a relative with lung cancer, or a low education level among other socioeconomic factors—should be included when evaluating a person’s eligibility for lung cancer screening. These findings were published in a research letter in JAMA Oncology.
“We know screening is effective, but these data show us that we really need to start thinking about more expansive, risk-based screening guidelines, especially if we want to close the gap when it comes to racial disparities in lung cancer outcomes,” stated lead author Mary M. Pasquinelli, MS, APRN, a nurse practitioner at UIC, in a UIC press release.
The current screening guidelines for lung cancer are based on the National Lung Screening Trial (NLST). In this trial, a 20% reduction in lung cancer mortality was reported when lung cancer was detected at an early stage with low-dose computed tomography scanning versus chest radiography for those at high risk based on age and smoking history. However, more than 90% of the participants in NLST were white.
Compared with the demographics of the NLST, patients in the UIC lung cancer screening program had a higher percentage of African American (69.6% vs. 4.5%) and Latino (10.6% vs. 1.8%) individuals. In addition, the UIC patients had double the number of positive scans (24.6% vs. 13.7%) and a higher percentage of diagnosed lung cancer cases (2.6% vs. 1.1%). The UIC study group consisted of 500 men and women who received their care at the University of Illinois Hospital and Clinics or the UI Health Mile Square Health Center.