Revised lung cancer screening guidelines still leave many high-risk groups ineligible
Updated guidelines for lung cancer screening designed to address longstanding disparities still fall woefully short of their intended goal, radiologists reported Tuesday.
Back in March, the U.S. Preventative Services Task Force said individuals should begin low-dose CT screening five years earlier than previously recommended, lowering the starting age from 55 to 50 and smoking pack-years from 30 to at least 20.
Millions more became eligible for LDCT exams overnight, but some experts said it wasn’t enough to ensure vulnerable patients are screened.
New survey results from tens of thousands of respondents published in Radiology solidified those concerns. Under the 2021 USPSTF update, 14.7% of white patients were eligible for screening, compared to 9.1% of Black individuals, 4.5% of Hispanics and 5.2% of Asian/ Pacific Islanders.
Massachusetts General Hospital experts applauded the overall gains in screening eligibility but warned the improvements still fall short.
“It was great to expand eligibility, but to just change the age and the pack-years doesn’t fully address lung cancer risk,” radiologist Anand K. Narayan, MD, PhD, vice chair of equity at the University of Wisconsin in Madison, and formerly of Massachusetts General Hospital, said in a statement. “We’ve long known that some racial/ethnic minorities face a higher risk of lung cancer, and that level of risk is not adequately reflected in the new guidelines.”
The conclusions are based on data from the 2019 Behavioral Risk Factor Surveillance System, which covered upwards of 77,000 people across 20 states.
If the USPSTF wants to truly address disparities, Narayan said guidelines must incorporate risk models. These approaches include variables such as family history and COPD and social factors like employment, education status and food insecurity
“If we put social determinants of health into our model, then we can more accurately reflect risk,” Narayan added. “It can give us tools to direct our resources toward patients in terms of how much risk they are experiencing and how much care they actually need. We can then target high-risk patients for more intensive screening and diagnostic services.”
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.