The answer to reducing racial disparities in the occurrence of lung cancer could be found in a Canadian prediction model.<\/p>\n
A Brock University-designed lung cancer prediction model has been found to be more effective at identifying African-Americans who should be screened for lung cancer than what is currently available in the American health-care system.<\/p>\n
A study published recently<\/a> found that Brock epidemiologist and Professor of Health Sciences Martin Tammem\u00e4gi\u2019s model identified up to 20 per cent more African-Americans who needed lung cancer screening than the United States Preventive Services Task Force (USPSTF) system.<\/p>\n The data is considered more comprehensive because his model uses a greater number and broader criteria than the American system to determine who is eligible for lung cancer screening.<\/p>\n \u201cFor a long time, it has been observed that African-Americans, in particular men, have elevated incidence of and mortality from lung cancer compared to white people and other racial or ethnic groups,\u201d says Tammem\u00e4gi, who is one of the study\u2019s authors.<\/p>\n The American Cancer Society<\/a> attributes much of the difference to African-Americans\u2019 \u201clower socioeconomic status and less access to medical care,\u201d noting that \u201cpeople with lower socioeconomic status face more barriers to high-quality health care, including lack of insurance.\u201d<\/p>\n But even when African-Americans do get pre-tested for lung cancer screening, they often fall through the cracks because the USPTF\u2019s testing criteria \u201cappear to be skewed toward white people, so disregarding race differences in lung cancer risk is expected to lead to under screening of African-American smokers, and exacerbate race disparities in lung cancer screening outcomes,\u201d says the study.<\/p>\n Two major U.S. organizations \u2014 the USPSTF and the Centers for Medicare and Medicaid Services (CMS) \u2014 have approved low-dose computed tomography (CT) lung cancer screening for high-risk individuals.<\/p>\n CT lung cancer screening detects earlier stages of cancer, which are often cured by surgery. Without screening, most lung cancers are detected at an advanced stage, with most cases being fatal.<\/p>\n To determine their eligibility for CT scanning, individuals are assessed according to a number of criteria. In the USPSTF and CMS models, people can receive CT scanning if they have smoked for 30 or more \u2018pack-years,\u2019 have quit within the last 15 years if they are former smokers, and if they are 55 to 80 years old in the USPSTF model or 55 to 77 years in the CMS model.<\/p>\n A pack-year is smoking one package a day for one year or its equivalent, for example, smoking a half-pack a day for two years.<\/p>\n The study calls the categorical pack-year\/quit-time assessment approach a \u201ccomparatively crude measure\u201d of someone\u2019s actual risk.<\/p>\n \u201cIn general, the USPSTF criteria is simplistic and narrow,\u201d says Tammem\u00e4gi.<\/p>\n In contrast, Tammem\u00e4gi\u2019s model, dubbed PLCOm2012, uses 11 factors including the number of cigarettes smoked per day, the number of years of smoking, race\/ethnicity, age, highest level of education obtained, family history of lung cancer, body mass index, among others \u2014 along with mathematical equations to predict the risk of an individual getting lung cancer.<\/p>\n