New USPSTF Lung Cancer Screening Guidelines Improve Representation of Black Patients

The US Preventive Services Task Force’s (USPSTF’s) extended guidelines on lung cancer screening have improved the representation of Black patients, according to the results of a recent study.

The eligibility criteria were expanded in 2021 to include patients aged between 50 and 80 years and lowered the cigarette pack-year history from 30 years to 20 years. The updates were put in place to further reduce lung cancer mortality and improve the screening eligibility among vulnerable individuals.

The researchers aimed to identify the differences between individuals who were eligible for lung cancer screening in 2013 vs individuals eligible in 2021 to understand the impact of the guidelines changes on diverse populations.

The researchers conducted a cross-sectional study and analyzed individuals who completed lung cancer screening between March 9, 2021, and December 9, 2021. Patients were identified through the team’s Lung Cancer Screening Program Registry.

A total of 815 individuals were categorized into 2 cohorts: a USPSTF 2013-eligible cohort (n = 654) and a USPSTF 2021-eligible cohort (n = 161). Participants in the 2013 cohort were aged 55 years or older, had at least 30-pack-year smoking history, and quit less than 15 years ago. Those in the 2021 cohort were aged 50 to 54 years or had a 20- to 29-pack-year smoking history, and quit less than 15 years ago. For the purpose of the study, individuals were identified by race, which included Black, White, and other (Alaskan Native or American Indian, Asian, Native Hawaiian, Pacific Islander, and more than 1 race).

After analyzing the results of the study, the researchers reported that the USPSTF 2021-eligible cohort had a greater proportion of Black individuals compared with the USPSTF 2013-eligible cohort (54.0% vs 39.5%; P = .02). individuals eligible under the new criteria also reported current smoking more frequently than those in the 2013 cohort (65.2% vs 55.0%; P = .02). No significant differences were observed between the cohorts for sex or education.

“Expansion of screening criteria is a critical first step to achieving equity in [lung cancer screening] for all high-risk populations, but myriad challenges remain before individuals enter the door for screening,” the researchers noted. “Health policy changes must occur simultaneously with efforts to expand community outreach, overcome logistical barriers, and facilitate screening adherence.”


—Jessica Ganga


Shusted CS, Evans NR, Kane GC, Juon HS, Barta JA. Analysis of lung cancer screening by race after USPSTF expansion of screening eligibility in 2021. JAMA Netw Open. 2022;5(6):e2217578. doi:10.1001/jamanetworkopen.2022.17578