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Summer S Han
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P1.11 - Screening and Early Detection (ID 177)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.11-03 - Disparities and National Lung Cancer Screening Guidelines in the U.S. Population (ID 1496)
09:45 - 18:00 | Presenting Author(s): Summer S Han
- Abstract
Background
Current U.S. Preventive Services Task Force (USPSTF) lung cancer (LC) screening guidelines are based on smoking history and age (55-80). These guidelines may miss those at higher risk, even at younger ages, due to other risk factors such as race or family history. In this study, we characterize the demographic/clinical profiles of those who are selected by risk-based screening criteria, but missed by USPSTF in younger (45-54) or older ages (71-80).
Method
We used data from the National Health Interview Survey, the CISNET Smoking History Generator, and logistic prediction models for non-smoking risk factors to simulate life-time LC risk-factor data for 100,000 men and women in the U.S. 1950-1960 birth cohorts. We calculated age-specific 6-year LC risk (r) for each individual from ages 45-90 using the PLCOm2012 model. We evaluated age-specific screening-eligibility by USPSTF guidelines and by risk-based criteria (varying thresholds between 1.3%-2.5%).
Result
In the 1950 cohort, 6.73% would be missed for screening in their younger ages by the USPSTF-criteria, but would have been screened by the risk-based criteria. Similarly, 13.97% of the cohort would be ineligible for screening by USPSTF in older ages. Notably, a higher proportion of African Americans will be ineligible for screening by USPSTF at younger (25.6%) or older (19.7%) ages, which is significantly higher than for Whites (7.7% and 15.75% respectively). Similar results were observed for other risk thresholds and for the 1960 cohort.
Conclusion
Further consideration is needed to incorporate comprehensive risk factors, including race/ethnicity, into lung screening criteria to reduce potential racial disparities.
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P2.01 - Advanced NSCLC (ID 159)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.01-73 - Outcome Disparities in American Indian/Alaskan Natives with Advanced Stage Lung Cancer (ID 2679)
10:15 - 18:15 | Author(s): Summer S Han
- Abstract
Background
Although there have been many advances in the treatment of lung cancer, outcomes for American Indian/Alaskan Natives (AI/AN) have remained poor. AI/AN patients present at a younger age, more advanced stage and have higher lung-cancer attributed mortality rates. While disparities in treatment of early stage lung cancer are well described, the pattern of treatment in advanced stage disease and cancer guideline concordance is incompletely understood.
Method
Data was obtained from the National Cancer Institute SEER database from 2000-2013, which was linked with Medicare enrollment and claims data from the Centers for Medicare and Medicaid Services. Patients were included if they were characterized as AI/AN by either SEER or Medicare databases and diagnosed with stage IIIB/IV lung cancer. Demographic data and clinical characteristics were abstracted. Metrics were developed to assess adherence with lung cancer treatment guidelines.
Result
Out of 238,439 lung cancer patients, 404 patients had advanced stage disease and were coded as AI/AN in SEER. They were propensity matched by age at diagnosis, year of diagnosis and number of lung cancers to a cohort of white advanced stage patients (N=404). The comparison of the patient characteristics across the two race groups shows that AI/AN patients were more likely to have squamous cell histology, live in smaller urban communities, less likely to be married, and less likely to receive surgery or radiation. Only 20.5% of the advanced lung cancer AI/AN population received appropriate therapy within 90 days of diagnosis compared with 29.5% of the propensity matched white cohort (p = 0.004).
Conclusion
AI/AN patients are less likely to receive cancer-directed care such as surgery or radiation than the matched white cohort and less likely to receive appropriate therapy within 90 days of diagnosis. Work is ongoing to evaluate adherence to other metrics such as receipt of appropriate diagnostics and treatment as well as trends in survival.
