Mary M Pasquinelli1, Martin C Tammemägi2, Kevin L Kovitz3, Marianne L Durham4, Zanë Deliu5, Kayleigh Rygalski6, Li Liu7, Matthew Koshy8, Patricia Finn3, Lawrence E Feldman5. 1. Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago, Chicago, Illinois. Electronic address: mpasqu3@uic.edu. 2. Department of Health Sciences, Brock University, St Catharines, Ontario, Canada. 3. Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago, Chicago, Illinois. 4. College of Nursing, University of Illinois at Chicago, Chicago, Illinois. 5. Division of Hematology and Oncology, University of Illinois at Chicago, Chicago, Illinois. 6. University of Illinois Cancer Center, University of Illinois at Chicago, Chicago, Illinois. 7. Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois. 8. Department of Radiation Oncology, University of Illinois at Chicago, Chicago, Illinois.
Abstract
INTRODUCTION: Disparities exist in lung cancer outcomes between African American and white people. The current United States Preventive Services Task Force (USPSTF) lung cancer screening eligibility criteria, which is based solely on age and smoking history, may exacerbate racial disparities. We evaluated whether the PLCOm2012 risk prediction model more effectively selects African American ever-smokers for screening. METHODS: Lung cancer cases diagnosed between 2010 and 2019 at an urban medical center serving a racially and ethnically diverse population were retrospectively reviewed for lung cancer screening eligibility based on the USPSTF criteria versus the PLCOm2012 model. RESULTS: This cohort of 883 ever-smokers comprised the following racial and ethnic makeup: 258 white (29.2%), 497 African American (56.3%), 69 Hispanic (7.8%), 24 Asian (2.7%), and 35 other (4.0%). Compared with the USPSTF criteria, the PLCOm2012 model increased the sensitivity for the African American cohort at lung cancer risk thresholds of 1.51%, 1.70%, and 2.00% per 6 years (p < 0.0001). For example, at the 1.70% risk threshold, the PLCOm2012 model identified 71.3% African American cases, whereas the USPSTF criteria only identified 50.3% (p < 0.0001). In contrast, in case of whites there was no difference (66.0% versus 62.4%, respectively [p = 0.203]). Of the African American ever-smokers who were PLCO1.7%-positive and USPSTF-negative, the criteria missed from the USPSTF were those with pack-years less than 30 (67.7%), quit time of greater than 15 years (22.5%), and age less than 55 years (13.0%). CONCLUSIONS: The PLCOm2012 model was found to be preferable over the USPSTF criteria at identifying African American ever-smokers for lung cancer screening. The broader use of this model in racially diverse populations may help overcome disparities in lung cancer screening and outcomes.
INTRODUCTION: Disparities exist in lung cancer outcomes between African American and white people. The current United States Preventive Services Task Force (USPSTF) lung cancer screening eligibility criteria, which is based solely on age and smoking history, may exacerbate racial disparities. We evaluated whether the PLCOm2012 risk prediction model more effectively selects African American ever-smokers for screening. METHODS:Lung cancer cases diagnosed between 2010 and 2019 at an urban medical center serving a racially and ethnically diverse population were retrospectively reviewed for lung cancer screening eligibility based on the USPSTF criteria versus the PLCOm2012 model. RESULTS: This cohort of 883 ever-smokers comprised the following racial and ethnic makeup: 258 white (29.2%), 497 African American (56.3%), 69 Hispanic (7.8%), 24 Asian (2.7%), and 35 other (4.0%). Compared with the USPSTF criteria, the PLCOm2012 model increased the sensitivity for the African American cohort at lung cancer risk thresholds of 1.51%, 1.70%, and 2.00% per 6 years (p < 0.0001). For example, at the 1.70% risk threshold, the PLCOm2012 model identified 71.3% African American cases, whereas the USPSTF criteria only identified 50.3% (p < 0.0001). In contrast, in case of whites there was no difference (66.0% versus 62.4%, respectively [p = 0.203]). Of the African American ever-smokers who were PLCO1.7%-positive and USPSTF-negative, the criteria missed from the USPSTF were those with pack-years less than 30 (67.7%), quit time of greater than 15 years (22.5%), and age less than 55 years (13.0%). CONCLUSIONS: The PLCOm2012 model was found to be preferable over the USPSTF criteria at identifying African American ever-smokers for lung cancer screening. The broader use of this model in racially diverse populations may help overcome disparities in lung cancer screening and outcomes.
Authors: Sarah Singh; Flaminio Pavesi; Katrina Steiling; Sainath Asokan; Cisco Espinosa; Howard J Cabral; Eric J Burks; Amanda Meister; Ogheneyoma Akpoviroro; Anne Buck; Kelly Drozdowicz; Virginia R Litle; Kei Suzuki Journal: Clin Lung Cancer Date: 2021-07-19 Impact factor: 4.785
Authors: Randi M Williams; Tengfei Li; George Luta; Min Qi Wang; Lucile Adams-Campbell; Rafael Meza; Martin C Tammemägi; Kathryn L Taylor Journal: Cancer Date: 2022-02-24 Impact factor: 6.860
Authors: Randi M Williams; Samuel A Kareff; Paul Sackstein; Tina Roy; George Luta; Chul Kim; Kathryn L Taylor; Martin C Tammemägi Journal: Lung Cancer Date: 2022-05-17 Impact factor: 6.081
Authors: Peter J Mazzone; Gerard A Silvestri; Lesley H Souter; Tanner J Caverly; Jeffrey P Kanne; Hormuzd A Katki; Renda Soylemez Wiener; Frank C Detterbeck Journal: Chest Date: 2021-07-13 Impact factor: 9.410
Authors: Peter J Mazzone; Gerard A Silvestri; Lesley H Souter; Tanner J Caverly; Jeffrey P Kanne; Hormuzd A Katki; Renda Soylemez Wiener; Frank C Detterbeck Journal: Chest Date: 2021-07-13 Impact factor: 9.410