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October 28, 2021

New lung cancer screening guidelines may benefit women and racial minorities

Lung cancer screening guidelines may apply to women and certain minority groups and more research is needed on the tobacco use requirement.

By GlobalData Healthcare

Lung cancer is the leading cause of cancer death among both men and women in the US. Almost 25% of all cancer deaths are due to lung cancer. The US Preventive Services Task Force (USPSTF) published its new recommendations for lung cancer screening last March. Under the new guidelines, adults ages 50 to 80 years who have a 20 pack-year smoking history and currently smoke, or have quit within the past 15 years, are eligible for annual lung cancer screening. Now, new research presented at the CHEST 2021 annual meeting in October reveals that the expanded USPSTF criteria may be beneficial for women and certain minority groups, whose lung cancers often occur at younger ages and with minimal or no tobacco use. As these revised guidelines are put into practice, GlobalData epidemiologists expect a subsequent increase in the number of diagnosed incident cases of lung cancer.

In a study by Vu and colleagues, published in Chest, a retrospective cohort study was conducted on 664 lung cancer patients seen at Los Angeles County Hospital and Norris Comprehensive Cancer Center from 2005–2015. The authors compared the number and demographics of patients who would have qualified for lung cancer screening based on the old (age ≥55 years, ≥30 pack-years) and updated USPSTF recommendations. When the new screening guidelines were used, they found a statistically significant increase in the number of patients that would have qualified for screening. The impact was particularly strong for Blacks, in which screening eligibility increased by 30%. Comparing men and women, screening eligibility increased by a little over 16% and 10%, respectively.

Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, responsible for 80–85% of cases. In the US, GlobalData epidemiologists expect diagnosed incident cases of NSCLC in adults to increase over the next decade, with cases exceeding 110,000 and 108,000 for men and women, respectively, by 2029 (as shown in Figure 1). However, with these new eligibility criteria, diagnosed incident cases of NSCLC may increase beyond those currently forecast as new cases of lung cancer are caught earlier. In particular, GlobalData epidemiologists expect the expanded USPSTF guidelines to diagnose more cases of lung cancer among women earlier, as lung cancer often occurs at a younger age in women.

Lowering the age and smoking thresholds in the USPSTF recommendations will ultimately allow lung cancer patients to be treated more promptly and lead to an improved prognosis, including among women and Blacks. Vu and colleagues call for additional research investigating if eliminating the tobacco use requirement would lead to additional success in diagnosing early lung cancer, especially among women and certain minority groups. GlobalData epidemiologists recommend continued monitoring of trends in lung cancer and additional studies to confirm these results and to consider the potential impact of further expanding the screening pool.

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