New 2021 USPSTF Lung Cancer Screening Criteria—An Opportunity to Mitigate Racial Disparity
Menée aux Etats-Unis à partir de données portant sur 912 patients atteints d'un cancer du poumon et 1 457 témoins, cette étude analyse l'intérêt, pour réduire les disparités ethniques dans l'accès au dépistage de la maladie, des critères 2021 de l'"US Preventive Services Task Force" par rapport à d'autres critères d'éligibilité
Although screening with a low-dose computed tomography scan of the chest can reduce lung cancer death, eligibility criteria disproportionately excluded African American patients at high risk for lung cancer. It is unknown whether new 2021 US Preventive Services Task Force (USPSTF) recommendations for lung cancer screening will mitigate this disparity. In this issue of JAMA Oncology, Pu et al compared the new lung cancer screening guidelines against the 2013 USPSTF guidelines, the National Comprehensive Cancer Network high-risk group 2 (NCCN group 2), and the Prostate Lung Colorectal and Ovarian Cancer Screening Trial (PLCO) criteria. This study retrospectively applied these lung cancer screening criteria to a registry of patients with or without lung cancer previously enrolled in the INHALE (Inflammation, Health, Ancestry, and Lung Epidemiology) study of the Karmanos Cancer Institute and Henry Ford Health System; in the INHALE study, 44% of participants were African American. Pu et al identified the patients with lung cancer who qualified for screening (sensitivity of criteria), similar to prior studies. The 2013 USPSTF criteria had a sensitivity of 49%, the NCCN group 2 criteria had a sensitivity of 62%, and both of these criteria demonstrated a disparity of eligibility among African American patients compared with non-Hispanic White patients. The 2021 USPSTF criteria and the PLCO criteria had greater sensitivity to include patients with lung cancer patients (2021 USPSTF criteria, 65%; PLCO criteria, 68%) compared with the USPSTF 2013 criteria and the NCCN group 2 criteria and was associated with the mitigation of disparity between the non-Hispanic White and African American cohorts.
JAMA Oncology , éditorial, 2021