Tailoring Lung Cancer Screening

African Americans who smoke have a higher risk of developing lung cancer than white American smokers, even though African Americans tend to smoke fewer cigarettes per day. A study published June 27 in JAMA Oncology suggests that guidelines for lung cancer screening should be different for African Americans and white Americans. Currently, the U.S. Preventive Services Task Force (USPSTF) recommends that people ages 55 through 80 who have smoked for 30 pack-years and who still smoke or have quit within the past 15 years should be screened for lung cancer using low-dose computed tomography. However, the study that served as the basis for these recommendations included just 4% African American participants. The new study focused on adult smokers or former smokers—two-thirds of whom were African American—living in the southern U.S. who were part of the Southern Community Cohort Study. The participants enrolled in the study from 2002 through 2009, and any cases of cancer in the group were recorded through 2014. Of the African American participants who went on to develop lung cancer, 32% were eligible for screening according to USPSTF guidelines, compared to 56% of white participants who developed lung cancer. “Our current lung cancer screening guidelines are woefully inadequate in providing equal opportunity for African Americans to be eligible for screening,” study co-author Melinda C. Aldrich of Vanderbilt University Medical Center in Nashville, Tennessee, told Reuters​. “It’s time to move the needle. If the guidelines continue as they are, they will potentially exacerbate racial disparities in lung cancer outcomes.”

3-D Mammograms Become More Common

Traditional digital mammography takes images of the breast from two angles. A technique called 3-D mammography, or digital breast tomosynthesis, creates images of the breasts from multiple angles. Randomized studies assessing 3-D mammography are still in progress. A study published June 24 in JAMA Internal Medicine looked at private insurance claims for screening mammograms. The proportion of mammograms that were 3-D rose from around 13% to 43% from early 2015 to late 2017. The new technique was adopted most quickly in the northeast and northwest regions of the U.S. and in areas where residents were more likely to be white and have higher incomes.

A Physician Writes About Aid in Dying

Thoracic oncologist Ross Camidge of the University of Colorado Cancer Center in Aurora is well known for his research into new therapies for lung cancer. In an article published June 26 in the Huffington Post​, he discusses a different topic: helping a patient die. Colorado’s Medical Aid in Dying (MAID) law allows people with a life expectancy of less than six months to go through a process to be prescribed drugs that will kill them. Camidge’s essay makes it clear that being part of the MAID process is not easy for him. But he also comes to feel he has a responsibility to be part of the process when asked. “MAID is going to happen,” Camidge writes. “And if it is to happen without misuse and mistrust, the physicians who know their patients the best should recognize the chances they give up to ensure that all other options have been talked through, to ensure the process is not abused and to really be there for their patients when they do not participate.”