2022 World Conference on Lung Cancer (ePosters)-EP01.06-007. The Impact of Modified Screening Eligibility Criteria on Race and Sex Disparities in Lung Cancer Screening

EP01.06-007. The Impact of Modified Screening Eligibility Criteria on Race and Sex Disparities in Lung Cancer Screening

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This study evaluated the impact of modified eligibility criteria for low-dose CT screening (LDCT) on rates of lung cancer detection by race and sex. The current eligibility criteria for LDCT underestimate the risk in women and racial minorities. The researchers compared variations of the US Preventive Services Task Force (USPSTF) LDCT eligibility criteria using data from a prospective observational cohort.<br /><br />The results showed that reducing smoking intensity and increasing quit-duration eligibility criteria increased the proportion of eligible women and Black individuals in a higher-risk cohort. The cohort consisted of 17,421 individuals with incidentally-detected lung nodules, with a median age of 65 years. Of this cohort, 28% were Black, and the additional eligible patients by USPSTF2021 were 27% Black compared to 17% eligible by USPSTF2013.<br /><br />Relaxing the USPSTF criteria resulted in a 48%, 42%, and 62% increase in eligible patients. The additional eligible individuals by the modified criteria were also significantly more likely to be Black and female.<br /><br />The key findings of the study include:<br /><br />1. Expanding the USPSTF criteria allowed screening for a higher proportion of women and Black individuals.<br />2. Further expansion to allow for longer quit time and reduced pack-years of smoking continued to identify a substantial number of additional lung cancers while reducing sex and race eligibility disparities.<br />3. The number of lung cancers identified per-person screened was slightly lower in the additional eligible individuals using the modified criteria, but still high.<br />4. Expanded lung screening criteria have a high yield of lung cancers identified and continue to address disparities.<br /><br />In summary, modifying the LDCT eligibility criteria increased the proportion of eligible women and Black individuals and identified a substantial number of additional lung cancers. These findings suggest that expanding the screening criteria can help address disparities in lung cancer detection.

Asset Subtitle

Matthew Smeltzer

Meta Tag

Speaker Matthew Smeltzer

Topic Early Detection and Screening - Risk Stratification

Keywords

low-dose CT screening

eligibility criteria

lung cancer detection

race

sex

observational cohort

smoking intensity

Black individuals

women

disparities