Screening Disparities Persist With Revised USPSTF Lung Cancer Screening Guideline

Screening disparities may still persist among women and racial/ethnic minority populations with the revised United States Preventive Services Task Force (USPSTF) lung cancer screening guideline, according to cross-sectional study results published in JAMA Network Open.

Lung cancer incidence and mortality disproportionately affect women and racial/ethnic minority populations; however, screening guidelines are based on clinical trials of predominantly White men. To reflect current data, the USPSTF has revised the eligibility criteria, which may help to improve sex- and race/ethnicity-related disparities in lung cancer screening. Therefore, researchers sought to determine the changes associated with the revised USPSTF guideline for lung cancer screening eligibility among female, Black, and Hispanic populations by evaluating respondents to the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System from January 1, 2017, to December 31, 2018 who were 50 to 80 years of age with a smoking history. Of 40,869 respondents, 21,265 (52.0%) were women, 3430 (8.4%) were Black, and 1226 (30.0%) were Hispanic.

The proportion eligible for screening among current and former smokers increased by 30.3% for men, 40.5% for women, and 31.9% for White, 76.7% for Black, and 78.1% for Hispanic populations. However, compared with men, the researchers found that women had lower odds of eligibility (adjusted odds ratio [aOR], 0.88; 95% CI, 0.79-0.99; P =.04), and compared with White individuals, Black and Hispanic individuals had lower odds of eligibility (aOR, 0.43; 95% CI, 0.33-0.56; P <.001 and aOR, 0.70, 95% CI, 0.62-0.80; P <.001, respectively).

“These findings suggest that female, Black, and Hispanic populations remain less likely to be eligible for lung cancer screening with the revised USPSTF guideline,” the authors wrote. “Eligibility criteria may need to be tailored for women and racial and ethnic minority populations to reduce inequities.”

Reference

Reese TJ, Schlechter CR, Potter LN, et al. Evaluation of revised US Preventive Services Task Force lung cancer screening guideline among women and racial/ethnic minority populations. JAMA Network Open. 2021;4(1):e2033769. doi:10.1001/jamanetworkopen.2020.33769