Studies have shown that the 2021 US Preventive Services Task Force guidelines improved the equality of lung cancer screening protocols for African American and White patients. Questions, however, remain regarding other racial and ethnic groups. To ascertain the validity of this hypothesis, Summer S. Han, PhD, and colleagues examined the precision of riskbased lung cancer screening and its potential to bridge the gap between racial and ethnic groups. The outcomes of this study were published in JAMA Oncology.

The Multiethnic Cohort Study (MEC), a prospective cohort study, was the foundation for this study’s population. MEC encompassed adults aged 45 to 75 enrolled in California and Hawaii between 1993 and 1996. A total of 105,261 participants with a history of smoking were identified, and of these, 45,250 were women. The mean age was 59.8, with a standard deviation of 8.7 years. This group included 18.3% African Americans, 25.9% Japanese Americans, 20.3% Latinos, 7.9% Native Hawaiians/Other Pacific Islanders, and 27.6% White participants.

Within the identified study population, 1,464 patients developed lung cancer within 6 years of enrollment. The 6-year lung cancer incidence was highest among African American patients, with a cancer rate of 2.2%. White and Native Hawaiian/Other Pacific Islanders had a lung cancer rate of 1.5%, Japanese Americans had a rate of 1.2%, and Latinos had the lowest rate of lung cancer at the 6-year mark, with 0.7%.

The predictive performance of PLCOm2012 was deemed promising, with an area under the curve (AUC) of 0.79 (95% CI, 0.78- 0.80). The researchers noted, however, that PLCOm2012 underestimated risk among Japanese Americans (calibration slope [CS]: 1.66), Latinos (CS: 2.45), and Native Hawaiians/Other Pacific Islanders (CS: 1.39). The researchers developed a re-calibrated model using MEC data and labeled the resulting model PLCOm2012-Update.

This adjustment improved the equality of results across all races and ethnicities observed in the study (range of CS: 0.79-1.4). As concluded in their published findings, Dr. Han and colleagues shared, “risk-based lung cancer screening using a validated risk prediction model may help reduce racial and ethnic disparities in lung cancer screening and improve screening efficiency across racial and ethnic groups in the US.”