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Screening guidelines for lung cancer may need revising

An illustration of human lungs.

July 15, 2019—Since 2013, the U.S. Preventive Services Task Force (USPSTF) has called for a yearly lung cancer screening for many current or former smokers.

The goal of screening is to find lung cancer before it causes symptoms. That's when potentially lifesaving treatments often work best.

But for African American people, the current recommendations misalign with their cancer risk and may put them at a disadvantage. So says a study in the journal JAMA Oncology.

Recommendations based on age and smoking history

The USPSTF guidelines use age and smoking history to suggest who should be screened. Both are risk factors for lung cancer.

Current guidelines recommend lung cancer screening for people:

  • Ages 55 to 80 who smoke or have quit smoking within the past 15 years.
  • Who have a 30 pack-year history of smoking. That's roughly equal to smoking one pack of cigarettes a day for 30 years.

For African American people, lung cancer poses a higher risk

For the study, the researchers involved 48,364 current and former smokers ages 40 to 79. They also looked at the number of new lung cancer cases among the participants, the majority of whom were African American.

Among the findings? Many African American people who developed lung cancer were not eligible for screening under the current USPSTF guidelines.

Of the smokers diagnosed with lung cancer, just 32% of African American smokers were eligible for screening. That's compared to 56% of white smokers.

That's a striking disparity, according to the research team.

Researchers also found that African American smokers who developed lung cancer:

  • Tended to smoke less than white smokers.
  • Were often diagnosed with lung cancer at an earlier age.

Because of these differences, many African American people could be missing their chance to spot lung cancer at an earlier stage, when their treatment options are broader and potentially more effective.

Calls for change

The USPSTF lung cancer screening guidelines should be revised, the researchers said—especially since many insurance companies use these guidelines to determine coverage.

For African American people, the research team proposed lowering:

  • The smoking history recommendation from 30 to 20 pack-years.
  • The minimum age requirement for screening to 50.

These changes could help more African American people at risk for lung cancer get the screening tests they need.

Learn more about lung cancer

Want to know more? Check out our Lung Cancer health topic center.

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