Current Lung Cancer Screening Guidelines Suboptimal in Identifying At-Risk Women

woman patient talking to doctor
female patient speaking to doctor
Current US Preventive Services Task Force guidelines are not applicable to most women at risk for lung cancer.

This article is part of Pulmonology Advisor‘s coverage of the CHEST 2019 meeting, taking place in New Orleans, LA. Our staff will report on medical research related to asthma, COPD, critical care medicine, and more conducted by experts in the field. Check back regularly for more news from CHEST 2019.

NEW ORLEANS — Current US Preventive Services Task Force (USPSTF) guidelines are not applicable to most women at risk for lung cancer, according to research results presented at the CHEST Annual Meeting 2019 held October 19-23, in New Orleans, Louisiana.

While USPSTF guidelines identify age and smoking history as prerequisites for lung cancer screening, 20% of lung cancers in the United States are not attributed to tobacco and the smoking prevalence in women is approximately one-fifth of that in men. Researchers hypothesized that a gender gap in lung cancer mortality may develop in the near future. Therefore, they conducted a retrospective cohort study of 294 women who were treated for lung cancer between 2005 and 2015 at Los Angeles County Hospital and Norris Comprehensive Cancer Center. Demographic data, including smoking status, family history of cancer, and lung cancer subtype were collected.

More than 80% of the women (n=237) did not meet USPSTF lung cancer screening criteria at the time of diagnosis. Reasons for exclusion included age (too young, 27.4%) and smoking status (75.1% had smoked <30 pack-years). In addition, the researchers noted that race and ethnicity may have been a factor because certain ethnicities tend to have a higher rate of nonsmoking-related lung cancers with genomic mutations (37.5% of the patients were Asian and 28.0% were Hispanic). A total of 83.5% of women who did not meet the screening criteria had lung cancers that were adenocarcinoma in histology and 48.1% had a family history of cancer.

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The investigators stated that until more research is done and low-dose chest computed tomography screening criteria are revised, lung cancer mortality trends in women will not improve.

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Vu C, Lin S, Chang C-F. Gender gaps in care: lung cancer screening criteria in women. Presented at: CHEST Annual Meeting 2019; October 19-23, 2019; New Orleans, LA. Abstract 407.