The 2021 CT lung cancer screening guidelines released by the U.S. Preventative Service Task Force (USPSTF) on March 9, 2021, were found to increase the “overall proportion of women, racial and ethnic minority groups, and individuals with lower socioeconomic status who are eligible for lung cancer screening,” according to a study published October 12, 2021, in JAMA Network Open.

The USPSTF had previously released CT screening guidelines in 2013. The new guidelines lowered “the screening age from 55 to 50 years and smoking history from 30 to 20 pack-years,” resulting in an eligibility increase for 18,533 individuals, or 53.7%. Further findings:

• The newly eligible 2021 population included 5833 individuals (31.5%) aged 50 to 54 years, a larger proportion of women (52.0% [n = 9631]), and more racial or ethnic minority groups.
• The relative increases in the proportion of newly eligible individuals were
  • 60.6% for Asian, Native Hawaiian, or Pacific Islander
  • 67.4% for Hispanic
  • 69.7% for non-Hispanic Black
  • 49.0% for non-Hispanic White groups
  • The relative increase for women was 13.8% higher than for men (61.2% vs 47.4%)
  • Those with a lower comorbidity burden and lower SES had higher relative increases (eg, 68.7% for a Charlson Comorbidity Index score of 0; 61.1% for lowest SES).
  • The 2021 recommendations were associated with an estimated 30% increase in incident lung cancer diagnoses compared with the 2013 recommendations.

Though the results, from five different community-based health centers, are promising, the study group cautions that community health centers have much to do. “Findings of the present study suggest that expanding the USPSTF recommendations for lung cancer screening eligibility is an important step toward minimizing disparities in lung cancer screening, but health care systems will still need to invest substantial resources to tailor outreach strategies and reduce barriers to lung cancer screening uptake for those with lower SES and for racial and ethnic minority groups. Ultimately, the value of the expanded guidelines will be realized only if lung cancer screening rates are increased in high-risk and traditionally underserved populations, particularly among non-Hispanic Black individuals, who have some of the highest rates of lung cancer mortality in the US.”

Sources:

Ritzwoller DP, Meza R, Carroll NM, et al. Evaluation of Population-Level Changes Associated With the 2021 US Preventive Services Task Force Lung Cancer Screening Recommendations in Community-Based Health Care Systems. JAMA Netw Open. 2021;4(10):e2128176. doi:10.1001/jamanetworkopen.2021.28176 Available online October 12, 2021, at https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2784816. Accessed October 25, 2021.

Yee, Kate. New CT lung cancer screening guide should fix healthcare inequities. AuntMinnie.com October 12, 2021. Available online at https://www.auntminnie.com/index.aspx?sec=sup&sub=cto&pag=dis&ItemID=133739. Accessed October 25, 2021.