Lung cancer screening guidelines may be inadequate for minorities, underrepresented populations

Current lung cancer screening guidelines, developed based on results from a 2011 study, may be inadequate for high-risk minorities and those in underrepresented communities, researchers at the University of Illinois at Chicago reported in a JAMA Oncology study this week.

First author of the study, Mary M. Pasquinelli, MS, APRN, and colleagues said in JAMA that present-day lung cancer screening recommendations might be outdated and can exclude groups of patients in underserved communities. National guidelines, written nearly a decade ago, are based on the National Lung Screening Trial and recommend screening based on age and smoking history.

The National Lung Screening Trial was comprised of just 4.5 percent black patients and 1.8 percent Latino individuals, according to the paper. In Pasquinelli et al.’s study group of 500 men and women who received care at the University of Illinois Hospital and Clinics or UI Mile Square Health Center, 69.6 percent of participants were black, and 10.6 were Latino.

“We know screening is effective, but these data show us that we really need to start thinking about more expansive, risk-based screening guidelines, especially if we want to close the gap when it comes to racial disparities in lung cancer outcomes,” Pasquinelli said in a release from UI. “Otherwise, continued use of screening guidelines that are skewed toward the white population could actually increase racial disparities in outcomes.”

She said her team’s work proves the national trial isn’t representative of all U.S. citizens—particularly minorities. The American Lung Association has reported that not only do black populations see higher rates of lung cancer, but they’re also more likely to die from it than white patients.

Lawrence E. Feldman, MD, an oncologist at the UI Hospital and professor of clinical medicine at the UIC College of Medicine, said in the release it was important to compare what was previously considered nationally representative data from that of a diverse, urban population.

“Immunotherapies and other advances in medicine have come a long way in extending life and improving quality of life for many individuals diagnosed with lung cancer, but those advances mean much less for people living in underserved communities who can’t access or are ineligible for screening programs,” he said. “Screening that is offered based only on age and smoking history may miss a large group of people who are at higher risk due to other factors.”