Researchers have developed an alternative set of simple criteria using a prediction model to identify groups of patients who may benefit most from lung cancer screening but are disproportionately excluded by current eligibility criteria, according to a new study published by Kearney et al in the Annals of Internal Medicine.
Study Methods and Results
In the new study, the researchers examined the responses of over 58 million adults with a smoking history who participated in the 1997 to 2018 annual National Health Interview Survey. They sought to determine whether alternative criteria would be more effective at identifying high-benefit groups.
The researchers used Fast and Frugal Tree algorithms and information as it was included in the U.S. Preventative Services Task Force (USPSTF) criteria to develop an alternative set of simple criteria. They then compared the alternative criteria to USPSTF criteria in their sensitivity and specificity to identify high-benefit groups as well as determined where the selected populations overlapped and where the alternative criteria overcame the USPSTF’s limitations.
The researchers found that these high-benefit groups included those who smoked for a long duration but at a lower intensity, individuals with a history of heavy smoking who quit over 15 years ago, and high-benefit individuals from racial and ethnic minorities.
The results indicated that the alternative criteria may have had a higher sensitivity and specificity in identifying high-benefit groups and was substantially more sensitive in identifying high-benefit individuals from racial and ethnic minorities compared with the USPSTF criteria. Additionally, analysis confirmed inequities in the current USPSTF criteria, which has a poor sensitivity for identifying high-benefit Black individuals for lung cancer screening.
Conclusions
The findings suggested that the alternative criteria could produce more effective lung cancer screening, lead to better support of ethical risk management, and substantially reduce racial disparities in lung cancer screening eligibility. The alternative criteria were found to be easy to remember and represent a feasible strategy to improve current lung cancer screening eligibility criteria. Beyond the lung cancer screening context, the researchers underscored that this approach may also be useful for other cancer screening and prevention modalities.
Disclosure: For full disclosures of the study authors, visit acpjournals.org.
