One size does not fit all: Evaluating disparities in lung cancer screening eligibility amongst Hispanic/LatinX and African Americans.

Authors

null

Coral Olazagasti

Northwell Health, New Hyde Park, NY

Coral Olazagasti , Matthew Ehrlich , Nina Kohn , Nagashree Seetharamu

Organizations

Northwell Health, New Hyde Park, NY, Northwell Health, Mineola, NY, Feinstein Institute for Medical Research, Manhasset, NY, Northwell Health Cancer Institute, Lake Success, NY

Research Funding

No funding received
None

Background: Lung cancer (LC) is the leading cause of cancer death among Hispanic men. African Americans (AA) have the highest LC mortality rate in the United States (US). We sought to identify the tendencies for screening eligibility amongst Hispanic/LatinX (H/L) and AA prior to their LC diagnosis according to the National Comprehensive Cancer Network (NCCN) and The United States Preventive Service Task Force (USPSTF) guidelines. Methods: We conducted an observational study in patients diagnosed with LC from 2016 to 2019. Current and former smokers were included in the analysis. Charts were reviewed for demographics, smoking history, family history, personal history of other malignancy, and prior exposures to assess screening their eligibility prior to LC. The chi-square test was used to examine the association between race and ethnicity with each screening criteria. Results: A total of 530 subjects were reviewed, of which 428 were included in the analysis. One hundred and fifty three and 245 subjects were ineligible for NCCN and USPSTF screening criteria prior to their LC diagnosis. Twenty-eight of the subjects failing to meet NCCN criteria identified as AA and 12 as H/L. Forty and 20 of the USPSTF ineligible subjects identified as AA and H/L. There was a significant association between ethnicity and individual screening eligibility, where 52% of H/L met NCCN eligibility compared to 20% of H/L who met USPSTF eligibility (p = 0.0010). There was a significant association between ethnicity and USPSTF criteria (p = 0.0166), as 80% of H/L subjects were screening ineligible under USPSTF criteria compared to 56% of non-Hispanic or other [Table]. Conclusions: In our study, H/L had significant lower tendencies of meeting the USPSTF LC screening eligibility criteria than non-H/L or other. Notably, there was a profound association between ethnicity and eligibility of screening criteria, where a proportionally higher number of H/L who were ineligible under USPSTF criteria met NCCN criteria. These findings suggest that leniency in the screening criteria can possibly lead to earlier detection of lung cancer in high-risk individuals. Our study is in line with developing data that minority individuals at high-risk for lung cancer can be missed, mainly if current USPSTF criteria was to be applied. Recently, USPSTF has modify their criteria which may benefit more of these individuals. To improve rates of screening and overall mortality of minorities, organizations should continue to re-evaluate and liberalize their screening guidelines.

Screening criteria eligibility per race and ethnicity.


NCCN Eligible


p-value
UPSSTF Eligible


p-value
Yes (%)
No (%)
Yes (%)No (%)
Race

African American

White, Asian, other


56.9

65.6


43.1

34.4
0.206


38.5

43.8


61.5

56.2
0.496
Ethnicity

Hispanic/LatinX

Non-Hispanic/LatinX


52.0

65.0


48.0

35.0
0.201


20.0

44.4


80.0

55.6
0.017

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Health Services Research and Quality Improvement

Track

Quality Care/Health Services Research

Sub Track

Access to Care

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 6538)

DOI

10.1200/JCO.2021.39.15_suppl.6538

Abstract #

6538

Poster Bd #

Online Only

Abstract Disclosures

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