Addressing Sex Disparities in Lung Cancer Screening Eligibility: USPSTF vs PLCOm2012 Criteria
Mary M Pasquinelli1, Martin C Tammemägi2, Kevin L Kovitz1
1Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago, Chicago, IL.
Chest
|July 12, 2021
Summary
The United States Preventative Services Task Force (USPSTF) lung screening guidelines show sex disparities in eligibility. The PLCOm2012 risk model improves lung cancer screening eligibility for women, reducing disparities.
Area of Science:
- Oncology
- Public Health
- Radiology
Background:
- Lung cancer is a leading cause of cancer death in US women.
- Screening trials indicate a greater mortality benefit for women than men.
- Current USPSTF guidelines may create sex disparities in lung cancer screening eligibility.
Purpose of the Study:
- To determine if USPSTF lung screening guidelines contribute to sex disparities in eligibility.
- To assess if the PLCOm2012 risk prediction model reduces these sex disparities.
Main Methods:
- Retrospective analysis of 883 lung cancer cases (Chicago Race Eligibility for Screening Cohort).
- Compared sensitivity of USPSTF 2013/2021 criteria vs. PLCOm2012 model (≥1.7%/6y and ≥1.0%/6y thresholds).
- Stratified eligibility analysis by sex.
Main Results:
- USPSTF 2021 criteria showed higher sensitivity than USPSTF 2013 but maintained sex disparities.
- PLCOm2012 model demonstrated higher sensitivity for both sexes compared to USPSTF.
- PLCOm2012 criteria (≥1.0%/6y) significantly reduced sex disparities in eligibility, with 27% of ineligible women becoming eligible.
Conclusions:
- USPSTF 2021 guidelines improve lung cancer screening sensitivity but do not eliminate sex disparities.
- Incorporating the PLCOm2012 risk model into USPSTF guidelines enhances screening sensitivity and reduces sex-based eligibility disparities.
- The PLCOm2012 model offers a more equitable approach to lung cancer screening eligibility for women.
