| dc.description | Lung cancer is the leading cause of cancer-related mortality, killing more people than breast, prostate, and colorectal cancer combined, with an overall 5-year survival of only 19%[1]. Histologically, it can be broadly characterized as either non-small cell lung cancer (NSCLC) or small cell carcinoma. Survival is strongly determined by the stage at which the cancer is diagnosed, as that stage influences the treatment options available for patients. For stage 1, localized, lung cancer, there is a 59.8% 5-year relative survival rate [2]. Whereas, for regional and distant lung cancer, the 5-year survival rates are only 32.9% and 6.3%, respectively [2]. Despite an encouraging survival rate from localized lung cancer, this only makes up 17.8% of nationwide diagnoses, lending the majority of cases to the low survival rates from regional and distant lung cancer. These data contribute to an increasing recognition of the value of diagnosing lung cancer early, as the current level of diagnosis at later stages is contributing to a high mortality rate.
The National Lung Screening Trial (NLST) showed that screening for lung cancer with low-dose computed tomography (LDCT) allows for early detection and reduces lung cancer mortality by 20% relative to chest x-ray [3]. As a result, the United States Preventive Services Task Force (USPSTF) set forth lung cancer screening guidelines in 2013 based on age (55-80 years) and smoking history, targeting smokers with a 30 pack-year history who either currently smoke or quit within the prior 15 years. These guidelines are based on data from the NLST, which was 91% White and only 4.4% African American [3]. While African Americans made up less than 5% of data collected from the NLST, they have among the highest rate of incidence of lung cancer in the United States [1]. These lung screening guidelines provide nationwide recommendations, but do not take into account the factors affecting various vulnerable populations, and the current disparities in lung cancer burden.
Smoking behaviors and pack-year history are considered in the screening guidelines as tobacco smoking was found to be the most significant risk factor for lung cancer (Bade Dela Cruz 2020). Over 4 million African Americans and 26 million Whites smoke and are at risk for lung cancer [4]. Despite smoking less on average, African Americans still have a greater smoking-adjusted risk of lung cancer, highlighting that presence of intervening social forces that contribute to disparities in disease burden and screening uptake. | en_US |
