The Screening U Give.

Top Line: Black patients comprised a whopping 4% of National Lung Screening Trial (NLST) participants.
The Study: As a result, the applicability of that approach in this minority population is less than certain. The Southern Community Cohort Study was designed to assess health disparities in mostly low-income minority communities in the Southeastern US. By linking with local tumor registries, incidence rates of lung cancer were linked with smoking histories to determine how applicable NLST criteria are in the black population. Over half of the nearly 85K participants were smokers, and two-thirds of those were black. And despite there being a higher rate of active smoking among black participants (63% versus 54% of white), they had lower median pack-years (18 versus 32) and smoked half as many cigarettes per day (10 versus 20). So, based on USPSTF criteria, only 17% of black patients compared to 31% of white were eligible for screening. Among patients diagnosed with an incident lung cancer (with no screening), those who were black had fewer pack years and were less likely to be eligible for screening at diagnosis (32% versus 57%). In other words, over two-thirds of black patients were ineligible for lung cancer screening at the time of lung cancer diagnosis, largely as a result of not meeting the pack-year requirement.
TBL: Current lung cancer screening criteria under-represent high-risk smoking patterns among black smokers leading to higher rates of incident lung cancer in screening ineligible patients. | Aldrich, JAMA Oncol 2019


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