Mary M Pasquinelli1, Martin C Tammemägi2, Kevin L Kovitz3, Marianne L Durham4, Zanë Deliu5, Arielle Guzman6, 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, IL. Electronic address: mpasqu3@uic.edu. 2. Department of Health Sciences, Brock University, St. Catharines, ON, Canada. 3. Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago, Chicago, IL. 4. College of Nursing, University of Illinois at Chicago, Chicago, IL. 5. Division of Hematology/Oncology, University of Illinois at Chicago, Chicago, IL. 6. University of Illinois Cancer Center, University of Illinois at Chicago, Chicago, IL. 7. School of Public Health, Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL. 8. Department of Radiation Oncology, University of Illinois at Chicago, Chicago, IL.
Abstract
BACKGROUND: Lung cancer is the leading cause of cancer death in women in the United States. Prospective randomized lung screening trials suggest a greater lung cancer mortality benefit from screening women compared with men. RESEARCH QUESTION: Do the United States Preventative Services Task Force (USPSTF) lung screening guidelines that are based solely on age and smoking history contribute to sex disparities in eligibility, and if so, does the use of the PLCOm2012 risk prediction model that is based on 11 predictors of lung cancer reduce sex disparities? STUDY DESIGN AND METHODS: This retrospective analysis of 883 lung cancer cases in the Chicago Race Eligibility for Screening Cohort (CREST) determined the sensitivity of USPSTF vs PLCOm2012 eligibility criteria, stratified according to sex. For comparisons vs the USPSTF 2013 and the recently published USPSTF 2021 (released March 9, 2021) eligibility criteria, the PLCOm2012 model was used with risk thresholds of ≥ 1.7%/6 years (6y) and ≥ 1.0%/6y, respectively. RESULTS: The sensitivities for screening by the USPSTF 2013 were 46.7% for women and 64.6% for men (P = .003) and by the USPSTF 2021 were 56.8% and 71.8%, respectively (P = .02). In contrast, the PLCOm2012 ≥ 1.7%/6y sensitivities were 64.6% and 70.4%, and the PLCOm2012 ≥ 1.0%/6y sensitivities were 77.4% and 82.4%. The PLCOm2012 differences in sensitivity using ≥ 1.7%/6y and ≥ 1.0%/6y thresholds between women and men were nonsignificant (both, P = .07). Compared with men, women were more likely to be ineligible according to the USPSTF 2021 criteria because their smoking exposures were < 20 pack-years (22.8% vs 14.8%; ORWomen vs Men, 1.70; 95% CI, 1.19-2.44; P = .002), and 27% of these ineligible women were eligible according to the PLCOm2012 ≥ 1.0%/6y criteria. INTERPRETATION: Although the USPSTF 2021 eligibility criteria are more sensitive than the USPSTF 2013 guidelines, sex disparities in eligibility remain. Adding the PLCOm2012 risk prediction model to the USPSTF guidelines would improve sensitivity and attenuate sex disparities.
BACKGROUND: Lung cancer is the leading cause of cancer death in women in the United States. Prospective randomized lung screening trials suggest a greater lung cancer mortality benefit from screening women compared with men. RESEARCH QUESTION: Do the United States Preventative Services Task Force (USPSTF) lung screening guidelines that are based solely on age and smoking history contribute to sex disparities in eligibility, and if so, does the use of the PLCOm2012 risk prediction model that is based on 11 predictors of lung cancer reduce sex disparities? STUDY DESIGN AND METHODS: This retrospective analysis of 883 lung cancer cases in the Chicago Race Eligibility for Screening Cohort (CREST) determined the sensitivity of USPSTF vs PLCOm2012 eligibility criteria, stratified according to sex. For comparisons vs the USPSTF 2013 and the recently published USPSTF 2021 (released March 9, 2021) eligibility criteria, the PLCOm2012 model was used with risk thresholds of ≥ 1.7%/6 years (6y) and ≥ 1.0%/6y, respectively. RESULTS: The sensitivities for screening by the USPSTF 2013 were 46.7% for women and 64.6% for men (P = .003) and by the USPSTF 2021 were 56.8% and 71.8%, respectively (P = .02). In contrast, the PLCOm2012 ≥ 1.7%/6y sensitivities were 64.6% and 70.4%, and the PLCOm2012 ≥ 1.0%/6y sensitivities were 77.4% and 82.4%. The PLCOm2012 differences in sensitivity using ≥ 1.7%/6y and ≥ 1.0%/6y thresholds between women and men were nonsignificant (both, P = .07). Compared with men, women were more likely to be ineligible according to the USPSTF 2021 criteria because their smoking exposures were < 20 pack-years (22.8% vs 14.8%; ORWomen vs Men, 1.70; 95% CI, 1.19-2.44; P = .002), and 27% of these ineligible women were eligible according to the PLCOm2012 ≥ 1.0%/6y criteria. INTERPRETATION: Although the USPSTF 2021 eligibility criteria are more sensitive than the USPSTF 2013 guidelines, sex disparities in eligibility remain. Adding the PLCOm2012 risk prediction model to the USPSTF guidelines would improve sensitivity and attenuate sex disparities.
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: Martin C Tammemägi; Mamta Ruparel; Alain Tremblay; Renelle Myers; John Mayo; John Yee; Sukhinder Atkar-Khattra; Ren Yuan; Sonya Cressman; John English; Eric Bedard; Paul MacEachern; Paul Burrowes; Samantha L Quaife; Henry Marshall; Ian Yang; Rayleen Bowman; Linda Passmore; Annette McWilliams; Fraser Brims; Kuan Pin Lim; Lin Mo; Stephen Melsom; Bann Saffar; Mark Teh; Ramon Sheehan; Yijin Kuok; Renee Manser; Louis Irving; Daniel Steinfort; Mark McCusker; Diane Pascoe; Paul Fogarty; Emily Stone; David C L Lam; Ming-Yen Ng; Varut Vardhanabhuti; Christine D Berg; Rayjean J Hung; Samuel M Janes; Kwun Fong; Stephen Lam Journal: Lancet Oncol Date: 2021-12-11 Impact factor: 41.316