Equalizing cancer screening

Alternative approach for lung cancer screening outperforms national guidelines

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National guidelines that rely on age and smoking exposure to recommend people for lung cancer screening are disproportionally failing minority populations, according to a new study.

A method incorporating additional information, including family history and health problems, more successfully eliminates racial disparities, the study found.

The findings, published Oct. 26, 2023, in JAMA Oncology, are based on data on a group of 105,261 U.S. residents with a history of smoking.

To compare the national guidelines with the alternative method, the researchers looked at the eligibility-to-incidence rate — the number of people in a group eligible for screening compared with the number of lung cancer cases found in that group over a certain time. Higher ratios imply adequate screening; lower ratios imply that some lung cancer cases are occurring in people who were not deemed eligible for screening.

Based on the national guidelines, white people had a ratio of 20.3, while African Americans had a ratio of 9.5. The alternative method did better at cutting disparities, resulting in a ratio of 18.4 for white people and 15.9 for African Americans.

The researchers hope that their findings will spur dialogue about how to devise more equitable guidelines for lung cancer screening.

Summer Han, PhD, associate professor of neurosurgery and of biomedical informatics is the study’s senior author.

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Krista Conger

Krista Conger is a Senior Science Writer in the Office of Communications. Email her at kristac@stanford.edu.

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