New lung cancer screening guidelines increases the eligibility for African American women by 50 percent

(Boston)—How do we increase detection of lung cancer in African American women? We revise screening guidelines.

In April 2021, the United States Preventive Services Taskforce (USPSTF) revised its guidelines for lung cancer screening by CT scan by lowering age eligibility from 55 to 50 years and reducing the requisite pack-years of smoking from 30 to 20.  The changes were designed, in part, to increase the proportion of Black individuals eligible for screening following recognition of their younger age at diagnosis and higher risk of lung cancer associated with fewer pack-years of smoking compared with White individuals.

Using data from the Black Women’s Health Study (BWHS), the researchers evaluated the proportion of women diagnosed with lung cancer who would have been eligible under the 2013 vs. 2021 USPSTF lung cancer screening guidelines. Under 2013 USPSTF guidelines, 22.7 percent of BWHS lung cancer patients who had a smoking history would have been eligible for lung cancer screening. Under the new 2021 guidelines, the proportion of women eligible for screening increased to 33.9 percent, representing a 50 percent increase in eligibility. In addition, removing the requirement that former smokers must have stopped smoking recently (within the past 15 years), increased the proportion of BWHS lung cancer patients who would have been eligible from 33.9 percent to 48.2 percent.

“Our findings indicate that the new guidelines will markedly increase the proportion of high-risk Black women considered eligible for lung cancer screening and suggest that removing the 15 years since quitting smoking criteria in the current guidelines may result in earlier detection and improved survival for Black women with lung cancer.” said corresponding author Julie Palmer, ScD, director of BU’s Slone Epidemiology Center and the Karin Grunebaum Professor in Cancer Research at Boston University School of Medicine.

These findings appear as a “Research Letter” in JAMA Oncology.

This work was supported by the National Institutes of Health (U01CA164974 to JRP).