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Tytuł:
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Using Prediction Models to Reduce Persistent Racial and Ethnic Disparities in the Draft 2020 USPSTF Lung Cancer Screening Guidelines.
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Autorzy:
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Landy R; Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
Young CD; Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, GA, USA.
Skarzynski M; Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
Cheung LC; Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
Berg CD; Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
Rivera MP; Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Robbins HA; International Agency for Research on Cancer, Lyon, France.
Chaturvedi AK; Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
Katki HA; Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
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Źródło:
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Journal of the National Cancer Institute [J Natl Cancer Inst] 2021 Nov 02; Vol. 113 (11), pp. 1590-1594.
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Typ publikacji:
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Journal Article; Research Support, N.I.H., Intramural; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: <2003-> : Cary, NC : Oxford University Press
Original Publication: Bethesda, Md., U. S. Dept. of Health, Education, and Welfare, Public Health Service, National Institutes of Health; Washington, for sale by the Supt. of Docs., U. S. Govt. Print. Off.
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MeSH Terms:
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Ethnicity*
Lung Neoplasms*/diagnosis
Lung Neoplasms*/prevention & control
Black or African American ; Early Detection of Cancer/methods ; Healthcare Disparities ; Humans ; United States/epidemiology ; White People
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References:
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Grant Information:
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001 International WHO_ World Health Organization; R03 CA245979 United States CA NCI NIH HHS; U19 CA203654 United States CA NCI NIH HHS
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Entry Date(s):
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Date Created: 20210105 Date Completed: 20220224 Latest Revision: 20240324
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Update Code:
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20240324
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PubMed Central ID:
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PMC8562965
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DOI:
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10.1093/jnci/djaa211
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PMID:
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33399825
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We examined whether draft 2020 United States Preventive Services Task Force (USPSTF) lung cancer screening recommendations "partially ameliorate racial disparities in screening eligibility" compared with the 2013 guidelines, as claimed. Using data from the 2015 National Health Interview Survey, USPSTF-2020 increased eligibility by similar proportions for minorities (97.1%) and Whites (78.3%). Contrary to the intent of USPSTF-2020, the relative disparity (differences in percentages of model-estimated gainable life-years from National Lung Screening Trial-like screening by eligible Whites vs minorities) actually increased from USPSTF-2013 to USPSTF-2020 (African Americans: 48.3%-33.4% = 15.0% to 64.5%-48.5% = 16.0%; Asian Americans: 48.3%-35.6% = 12.7% to 64.5%-45.2% = 19.3%; Hispanic Americans: 48.3%-24.8% = 23.5% to 64.5%-37.0% = 27.5%). However, augmenting USPSTF-2020 with high-benefit individuals selected by the Life-Years From Screening with Computed Tomography (LYFS-CT) model nearly eliminated disparities for African Americans (76.8%-75.5% = 1.2%) and improved screening efficiency for Asian and Hispanic Americans, although disparities were reduced only slightly (Hispanic Americans) or unchanged (Asian Americans). The draft USPSTF-2020 guidelines increased the number of eligible minorities vs USPSTF-2013 but may inadvertently increase racial and ethnic disparities. LYFS-CT could reduce disparities in screening eligibility by identifying ineligible people with high predicted benefit regardless of race and ethnicity.
(Published by Oxford University Press 2021. This work is written by US Government employees and is in the public domain in the US.)
Comment in: J Natl Cancer Inst. 2021 Nov 2;113(11):1447-1448. (PMID: 33399822)
Comment in: AJR Am J Roentgenol. 2021 Sep;217(3):769. (PMID: 33759560)
