Potential Racial Disparities Using Current Lung Cancer Screening Guidelines.

Area of Science:

• Oncology
• Public Health
• Epidemiology

Background:

• Current lung cancer screening guidelines recommend initiating screening at age 55.
• These guidelines were based on trials with limited African American representation (4.4%).
• African Americans experience higher lung cancer incidence and younger age of onset.

Purpose of the Study:

• To evaluate the frequency of early-onset lung cancers in African Americans compared to White populations.
• To assess the stage at diagnosis for early-onset lung cancers in a biracial cohort.
• To determine if the current age threshold for lung cancer screening adequately addresses early-onset cases in African Americans.

Main Methods:

• Utilized Surveillance, Epidemiology, and End Results (SEER) Program data (SEER 18 registry, 2004-2014).
• Identified microscopically confirmed lung cancer cases (primary site code C34).
• Defined early-onset cancers as diagnoses in individuals aged 45 to 54 years; stratified by race and age group; employed chi-square tests for comparisons.

Main Results:

• Nearly 9% of 468,403 lung cancers were early-onset.
• Early-onset lung cancer frequency was higher in African Americans (14.2%) versus Whites (8.2%), p < 0.05.
• African Americans had significantly higher age-adjusted incidence rates, particularly in the 50-54 age group, and were more likely diagnosed at advanced stages.

Conclusions:

• The current lung cancer screening age threshold of 55 may miss a significant proportion of early-onset lung cancer cases in African Americans.
• Higher incidence and younger onset in African Americans necessitate further investigation into tailored screening age criteria.
• Additional research is required to establish appropriate lung cancer screening guidelines for the African American population.