Olazagasti Coral, Ehrlich Matthew, Seetharamu Nagashree
Division of Medical Oncology at Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, United States.
New York Presbyterian/Columbia University Medical Center, New York, NY, United States.
Front Oncol. 2022 Nov 1;12:995408. doi: 10.3389/fonc.2022.995408. eCollection 2022.
Lung cancer (LC) is the leading cause of cancer death among Hispanic men. We assessed the tendencies for screening eligibility amongst Hispanic prior to LC diagnosis according to the NCCN and The USPSTF guidelines available at the time of diagnosis. We conducted an observational study in patients diagnosed with LC from 2016 to 2019. Charts were reviewed to assess their screening eligibility prior to LC. The chi-square test was used to examine the association between race and ethnicity with each screening criteria. A total of 530 subjects were reviewed, of which 432 were included in the analysis. One hundred fifty-three and 245 subjects were ineligible for screening under NCCN and USPSTF criteria prior to their LC diagnosis. Twenty-eight of the subjects who did not fulfill NCCN criteria identified as AA and 12 as Hispanics. Forty and 20 of the USPSTF screening ineligible subjects identified as AA and Hispanics. There was a significant association between screening eligibility criteria in Hispanics, with 52% Hispanic subjects meeting NCCN criteria compared to only 20% who met USPSTF (p=0.0184). There was also a significant association between ethnicity and USPSTF eligibility criteria (p=0.0166), as 80% of Hispanic subjects were screening ineligible under USPSTF criteria compared to 56% of non-Hispanic or other. In our study, Hispanics had significantly lower tendencies of meeting the USPSTF LC screening eligibility criteria than non-Hispanics or other. Interestingly, a proportionally higher number of Hispanics 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 LC in high-risk individuals. Recently, USPSTF has modified 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.
肺癌(LC)是西班牙裔男性癌症死亡的主要原因。我们根据诊断时可用的美国国立综合癌症网络(NCCN)和美国预防服务工作组(USPSTF)指南,评估了西班牙裔在肺癌诊断前符合筛查条件的倾向。我们对2016年至2019年被诊断为肺癌的患者进行了一项观察性研究。回顾病历以评估他们在肺癌诊断前的筛查资格。采用卡方检验来检验种族与每种筛查标准之间的关联。总共审查了530名受试者,其中432名纳入分析。在肺癌诊断前,根据NCCN和USPSTF标准,分别有153名和245名受试者不符合筛查条件。未达到NCCN标准的受试者中,28名被认定为非裔美国人,12名被认定为西班牙裔。在USPSTF筛查不符合条件的受试者中,40名被认定为非裔美国人,20名被认定为西班牙裔。西班牙裔的筛查资格标准之间存在显著关联,52%的西班牙裔受试者符合NCCN标准,而符合USPSTF标准的仅为其中的20%(p = 0.0184)。种族与USPSTF资格标准之间也存在显著关联(p = 0.0166),因为根据USPSTF标准,80%的西班牙裔受试者不符合筛查条件,而非西班牙裔或其他种族的这一比例为56%。在我们的研究中,西班牙裔符合USPSTF肺癌筛查资格标准的倾向显著低于非西班牙裔或其他种族。有趣的是,在USPSTF标准下不符合条件的西班牙裔中,符合NCCN标准的比例相对较高。这些发现表明,筛查标准的放宽可能会导致高危个体更早地检测出肺癌。最近,USPSTF修改了他们的标准,这可能会使更多这类个体受益。为了提高少数族裔的筛查率和总体死亡率,各组织应继续重新评估并放宽其筛查指南。