Recommendations for screening with low-dose computed tomography in the 2013 lung cancer guidelines from the United States Preventive Services Task Force (USPSTF) were based largely on the results of a study in which 90% of participants were Caucasian and 59% were male. With research indicating that African Americans are more likely to get lung cancer than Caucasians and that African-American men are more likely to die from lung cancer than Caucasian men, study investigators reviewed 1,500 medical records of patients with newly diagnosed stage 1-4 lung cancers. Among the patients, one-third were diagnosed before age 55, meaning they did not meet the USPSTF screening guidelines. Based on NCCN risk stratification guidelines, 12.5% of screening-ineligible patients (>65% of whom were African American) would have been categorized as high risk and therefore recommended for LDCT. A since-created draft recommendation from the USPSTF states that they would recommend that screening start at age 50 years, rather than 55, and that the pack-years of smoking history that would make an individual eligible for screening would be dropped from 30 pack-years to 20.
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