New Study Says Expansion of USPSTF Lung Cancer Screening Eligibility May be Reducing Racial Disparities

New research out of Thomas Jefferson University suggests that the March 2021 expansion of lung cancer screening eligibility by the United States Preventive Services Taskforce (USPSTF) may be having an impact in improving screening access for African Americans.

The researchers compared a lung cancer screening cohort using 2013 USPSTF guidelines (minimum screening age of 55 and smoking intensity screening threshold of 30 pack years) to a screening cohort using 2021 USPSTF guidelines (minimum screening age of 50 and smoking intensity screening threshold of 20 pack years). The 2013 cohort consisted of 654 patients and the 2021 cohort consisted of 161 patients who were screened in the first nine months after the revised USPSTF guidelines.

According to the study findings, published in JAMA Network Open, the 2021 screening cohort had a significantly higher proportion of African Americans (54 percent) in comparison to the 2013 screening cohort (39.5 percent).

“This increase in the proportion of African Americans screened is encouraging as published data indicates that African Americans, specifically, will have a greater benefit, defined as more lives saved from lung cancer screening,” said study co-author Christine Shusted, MPH, an academic lung cancer screening data analyst at Thomas Jefferson University.

In a February article on the expansion of lung cancer screening guidelines by the Centers for Medicare and Medicaid Services (CMS), Anupam Basu, M.D., MBA noted that the reduced screening threshold from 30 pack years to 20 pack years would be particularly impactful in expanding lung cancer screening access for minorities.

“The 20 pack year threshold is much more realistic and thus will hopefully make a large dent in the number of minority populations that are eligible to be screened,” noted Dr. Basu, an associate professor at Rush University Medical Center in Chicago.

Addressing socioeconomic issues and elevating awareness of the benefits and availability of lung cancer screening are also keys to closing the gap with racial screening disparities, according to Julie Barta, M.D., the senior author of the study, assistant professor of medicine at Thomas Jefferson University and co-lead of the Lung Cancer, Screening and Nodules Program at the Jane and Leonard Korman Respiratory Institute.

“We are well aware that changing guidelines is only a first step to improving screening uptake and reducing cancer disparities,” noted Dr. Barta. “For many, significant barriers persist long before a patient even enters the exam room, such as lack of transportation, limited clinic hours, as well as attitudes and beliefs surrounding health care and smoking.”

The study authors added there were no significant differences between the 2013 and 2021 USPSTF cohorts in regard to gender, education or Lung-RADS results

In addition to the data coming from one institution, the study authors said another limitation of the research was low enrollment of minority patients who were not African American.