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Racial and Ethnic Disparities in Lung Cancer Screening by the 2021 USPSTF Guidelines Versus Risk-Based Criteria: The Multiethnic Cohort Study
BACKGROUND: In 2021, the US Preventive Services Task Force (USPSTF) revised its lung cancer screening guidelines to expand screening eligibility. We evaluated screening sensitivities and racial and ethnic disparities under the 2021 USPSTF criteria vs alternative risk-based criteria in a racially and...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9156850/ https://www.ncbi.nlm.nih.gov/pubmed/35642317 http://dx.doi.org/10.1093/jncics/pkac033 |
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author | Aredo, Jacqueline V Choi, Eunji Ding, Victoria Y Tammemägi, Martin C ten Haaf, Kevin Luo, Sophia J Freedman, Neal D Wilkens, Lynne R Le Marchand, Loïc Wakelee, Heather A Meza, Rafael Park, Sung-Shim Lani Cheng, Iona Han, Summer S |
author_facet | Aredo, Jacqueline V Choi, Eunji Ding, Victoria Y Tammemägi, Martin C ten Haaf, Kevin Luo, Sophia J Freedman, Neal D Wilkens, Lynne R Le Marchand, Loïc Wakelee, Heather A Meza, Rafael Park, Sung-Shim Lani Cheng, Iona Han, Summer S |
author_sort | Aredo, Jacqueline V |
collection | PubMed |
description | BACKGROUND: In 2021, the US Preventive Services Task Force (USPSTF) revised its lung cancer screening guidelines to expand screening eligibility. We evaluated screening sensitivities and racial and ethnic disparities under the 2021 USPSTF criteria vs alternative risk-based criteria in a racially and ethnically diverse population. METHODS: In the Multiethnic Cohort, we evaluated the proportion of ever-smoking lung cancer cases eligible for screening (ie, screening sensitivity) under the 2021 USPSTF criteria and under risk-based criteria through the PLCO(m2012) model (6-year risk ≥1.51%). We also calculated the screening disparity (ie, absolute sensitivity difference) for each of 4 racial or ethnic groups (African American, Japanese American, Latino, Native Hawaiian) vs White cases. RESULTS: Among 5900 lung cancer cases, 43.3% were screen eligible under the 2021 USPSTF criteria. Screening sensitivities varied by race and ethnicity, with Native Hawaiian (56.7%) and White (49.6%) cases attaining the highest sensitivities and Latino (37.3%), African American (38.4%), and Japanese American (40.0%) cases attaining the lowest. Latino cases had the greatest screening disparity vs White cases at 12.4%, followed by African American (11.2%) and Japanese American (9.6%) cases. Under risk-based screening, the overall screening sensitivity increased to 75.7%, and all racial and ethnic groups had increased sensitivities (54.5%-91.9%). Whereas the screening disparity decreased to 5.1% for African American cases, it increased to 28.6% for Latino cases and 12.8% for Japanese American cases. CONCLUSIONS: In the Multiethnic Cohort, racial and ethnic disparities decreased but persisted under the 2021 USPSTF lung cancer screening guidelines. Risk-based screening through PLCO(m2012) may increase screening sensitivities and help to reduce disparities in some, but not all, racial and ethnic groups. Further optimization of risk-based screening strategies across diverse populations is needed. |
format | Online Article Text |
id | pubmed-9156850 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-91568502022-06-04 Racial and Ethnic Disparities in Lung Cancer Screening by the 2021 USPSTF Guidelines Versus Risk-Based Criteria: The Multiethnic Cohort Study Aredo, Jacqueline V Choi, Eunji Ding, Victoria Y Tammemägi, Martin C ten Haaf, Kevin Luo, Sophia J Freedman, Neal D Wilkens, Lynne R Le Marchand, Loïc Wakelee, Heather A Meza, Rafael Park, Sung-Shim Lani Cheng, Iona Han, Summer S JNCI Cancer Spectr Article BACKGROUND: In 2021, the US Preventive Services Task Force (USPSTF) revised its lung cancer screening guidelines to expand screening eligibility. We evaluated screening sensitivities and racial and ethnic disparities under the 2021 USPSTF criteria vs alternative risk-based criteria in a racially and ethnically diverse population. METHODS: In the Multiethnic Cohort, we evaluated the proportion of ever-smoking lung cancer cases eligible for screening (ie, screening sensitivity) under the 2021 USPSTF criteria and under risk-based criteria through the PLCO(m2012) model (6-year risk ≥1.51%). We also calculated the screening disparity (ie, absolute sensitivity difference) for each of 4 racial or ethnic groups (African American, Japanese American, Latino, Native Hawaiian) vs White cases. RESULTS: Among 5900 lung cancer cases, 43.3% were screen eligible under the 2021 USPSTF criteria. Screening sensitivities varied by race and ethnicity, with Native Hawaiian (56.7%) and White (49.6%) cases attaining the highest sensitivities and Latino (37.3%), African American (38.4%), and Japanese American (40.0%) cases attaining the lowest. Latino cases had the greatest screening disparity vs White cases at 12.4%, followed by African American (11.2%) and Japanese American (9.6%) cases. Under risk-based screening, the overall screening sensitivity increased to 75.7%, and all racial and ethnic groups had increased sensitivities (54.5%-91.9%). Whereas the screening disparity decreased to 5.1% for African American cases, it increased to 28.6% for Latino cases and 12.8% for Japanese American cases. CONCLUSIONS: In the Multiethnic Cohort, racial and ethnic disparities decreased but persisted under the 2021 USPSTF lung cancer screening guidelines. Risk-based screening through PLCO(m2012) may increase screening sensitivities and help to reduce disparities in some, but not all, racial and ethnic groups. Further optimization of risk-based screening strategies across diverse populations is needed. Oxford University Press 2022-05-10 /pmc/articles/PMC9156850/ /pubmed/35642317 http://dx.doi.org/10.1093/jncics/pkac033 Text en © The Author(s) 2022. Published by Oxford University Press. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Article Aredo, Jacqueline V Choi, Eunji Ding, Victoria Y Tammemägi, Martin C ten Haaf, Kevin Luo, Sophia J Freedman, Neal D Wilkens, Lynne R Le Marchand, Loïc Wakelee, Heather A Meza, Rafael Park, Sung-Shim Lani Cheng, Iona Han, Summer S Racial and Ethnic Disparities in Lung Cancer Screening by the 2021 USPSTF Guidelines Versus Risk-Based Criteria: The Multiethnic Cohort Study |
title | Racial and Ethnic Disparities in Lung Cancer Screening by the 2021 USPSTF Guidelines Versus Risk-Based Criteria: The Multiethnic Cohort Study |
title_full | Racial and Ethnic Disparities in Lung Cancer Screening by the 2021 USPSTF Guidelines Versus Risk-Based Criteria: The Multiethnic Cohort Study |
title_fullStr | Racial and Ethnic Disparities in Lung Cancer Screening by the 2021 USPSTF Guidelines Versus Risk-Based Criteria: The Multiethnic Cohort Study |
title_full_unstemmed | Racial and Ethnic Disparities in Lung Cancer Screening by the 2021 USPSTF Guidelines Versus Risk-Based Criteria: The Multiethnic Cohort Study |
title_short | Racial and Ethnic Disparities in Lung Cancer Screening by the 2021 USPSTF Guidelines Versus Risk-Based Criteria: The Multiethnic Cohort Study |
title_sort | racial and ethnic disparities in lung cancer screening by the 2021 uspstf guidelines versus risk-based criteria: the multiethnic cohort study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9156850/ https://www.ncbi.nlm.nih.gov/pubmed/35642317 http://dx.doi.org/10.1093/jncics/pkac033 |
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