487P - Evaluating the performance of the USPSTF lung cancer screening guidelines in an Asian population of lung cancer patients

Background

The United States Preventive Services Task Force (USPSTF) recommends low dose CT screening for lung cancer in individuals (1) 50-80 years old, (2) currently smoking or had quit for less than 15 years and (3) had at least a 20 pack-year smoking history. It is unclear if these guidelines will be applicable to our mixed Asian population. Our aim is to evaluate the performance of the USPSTF lung cancer screening criteria in our population of lung cancer patients.

Methods

We retrospectively reviewed the records of all asymptomatic patients who underwent resection of primary lung cancer in our institution between 2019 and 2021. Data collected included demographics, smoking status, histology and the final staging.

Results

We reviewed 259 consecutive cases of resectable primary lung cancer patients between 2019 and 2021. 145 patients were males (56.0%) and 114 patients were females (44.0%). There were 123 (47.5%) active or former smokers and 136 (52.5%) non-smokers. 83 patients (32.0%) met the USPSTF screening criteria and 176 patients (68.0%) did not. Lowering the age criteria to 45 years old increased the pickup rate to 34.4%. Male patients were more likely to meet the criteria (OR 2.27, 95% CI 1.87-2.76, p < 0.001) than female patients. The pickup rate increased significantly to 40.5% when patients who had stopped smoking for more than 15 years were included (p < 0.001) and 44.4% (p < 0.001) when patients who smoked less than 20 pack years were included. Screening by age criteria alone resulted in a pickup rate of 93.8% (males 94.5%, females 93.0%). Within this age range, the pickup rate in females was 84.2% in non-smokers and 8.8% in active or former smokers whilst the pickup rate in male was 22.1% in non-smokers and 72.4% in active or former smokers.

Conclusions

Our study showed the performance of the USPSTF criteria when applied to a mixed Asian population. It is concerning that more than two-thirds of patients will miss the opportunity for early curative resection if the guidelines were followed. A significant proportion of our patients were non-smokers, especially in the female population. A lung screening programme will need to be refined from existing guidelines to fit our local mixed Asian population.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.