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New Lung Cancer Screening Guidelines, Disparities and Need for Research

On Tuesday, March 9, 2021, the U.S. Preventive Services Task Force (USPSTF) announced its new lung cancer screening guidelines. 

The new recommendations now include people ages 50 to 80 who have smoked at least one pack a day for 20 years and who still smoke or have quit within the past 15 years. This will nearly double the number of people eligible for yearly low-dose computerized tomography (CT) scans. 

According to a “New York Times” article:

“Those changes will add more women and African-Americans to the pool eligible for screening, because they tend to smoke less heavily than the white male study participants on whom earlier guidelines were based. Women and Black Americans also tend to develop lung cancer earlier and from less tobacco exposure than do white men, experts said. Why the risk appears to differ by race and gender is not known.”

Increasing eligibility is a positive step, yet significant barriers remain, such as stigma associated with the disease itself, underrepresentation of non-or never-smokers in the guidelines, and access and affordability of CT-scans in underserved populations. Understanding how race and gender affect the development and progression of lung cancer is critical to be able to diagnose at earlier, more responsive stages. Engaging Black patients in clinical trial participation and lung cancer research will help to address these disparities. 

A 2020 Lung Cancer Research Foundation (LCRF) grant recipient and oncologist at UNC School of Medicine, Dr. Marjory Charlot, commented, “I agree with others that it is unclear why Black patients with lung cancer tend to be diagnosed at a younger age. It is also unclear why Black men have disproportionate mortality from lung cancer compared to other racial and ethnic groups and women with lung cancer. I believe that we need to start evaluating the influence of the social determinants of health, specifically structural racism, to help guide our investigation of why these racial and gender differences in lung cancer incidence and mortality disproportionately impact Black men.”

Another 2020 LCRF-funded grant aims to develop lung cancer risk prediction tools for Black Americans and Hispanic Americans, tackling the issue of current screening guidelines and its limitations with underserved groups. This would allow screening eligibility to be defined in a way that is fully equitable across racial and ethnic groups.

Later this year, LCRF will be launching Lung Cancer: A Guide for Black Americansan awareness and education program in partnership with the African Methodist Episcopal (AME) Church Health CommissionThis collaboration will help to increase knowledge and understanding of lung cancer, as well as encourage participation in clinical trials and research.

“At LCRF, we actively fund research to address health disparities in lung cancer,” says Eugene Manley, Jr., Director of Scientific Programs. “Our commitment is to bring a more equitable approach to the study, detection, and treatment of lung cancer.”

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