Abstract 1735P
Background
Among long-term cancer survivors (i.e., survived > 5 years since most recent cancer diagnosis) with a non-lung primary cancer, second primary lung cancer (SPLC) has the highest incidence (19%) and mortality (32%) rate among all secondary primary cancers. There are currently no separate screening guidelines for SPLC, though most providers have adopted the general USPSTF recommendation for lung cancer screening (LCS) in cancer survivors. We aimed to assess the differences in LCS eligibility rates among long-term cancer survivors under the USPSTF 2013 vs revised 2021 guidelines.
Methods
Smokers aged 50-79 years were selected from the 2017-2021 US Behavioral Risk Factor Surveillance System data. We assessed the eligibility of LCS using USPSTF 2013 criteria: current or former smokers (quit ≤ 15 years), 55-80 years of age and ≥ 30 pack-year smoking history, and the revised 2021 criteria (expanding age to 50-80 and pack-year to 20) in long-term cancer survivors. Weighted chi-square tests were used with SAS (9.4).
Results
A weighted total of 17,544,768 smokers were selected (2.7% were cancer survivors). The LCS eligibility rate of long-term cancer survivors using the 2013 criteria was similar to the non-cancer survivors (21.1% vs 22.4%; p=0.62) but lower when using the 2021 criteria (31.5% vs 38.0%; p=0.03). The 2021 criteria increased eligibility for long-term cancer survivors across all groups (Table). However, the degree of increase in eligibility rate in cancer survivors was lower than in non-cancer survivors.
Table: 1735P
Weighted eligibility rate % (95%CI) | Long-term cancer survivors (CS) | Δ % in CS | Δ % in non-CS | p-value* | |
2013 USPSTF | 2021 USPSTF | ||||
Overall | 21.1 (16.0-26.2) | 31.5 (26.0-37.1) | 10.4 | 15.6 | <0.01 |
Gender | |||||
Women | 20.5 (13.9-27.1) | 34.3 (27.3-41.5) | 13.8 | 15.8 | 0.43 |
Men | 21.6 (14.0-29.2) | 29.1 (20.9-37.4) | 7.5 | 15.4 | <0.001 |
Race | |||||
Non-Hispanic White | 23.2 (17.4-29.0) | 34.0 (27.8-40.1) | 10.8 | 16.1 | <0.01 |
Non-Hispanic Black | 9.9 (0.2-19.6) | 16.6 (4.3-29.9) | 6.7 | 14.2 | 0.08 |
Other races | 9.0 (0.0-19.0) | 21.5 (2.4-40.5) | 12.5 | 13.5 | 0.90 |
*P-value compares non-cancer survivors vs cancer survivors in the change of eligibility rate from 2013 to 2021 USPSTF criteria.
Conclusions
The increase in eligibility from the revised 2021 USPSTF appears to be less in long-term cancer survivors than in non-cancer survivors. Cancer survivors are facing a significant burden from SPLC due to their prior diagnostic tests and treatments (e.g., chest irradiation), genetic susceptibility, and shared risk factors. Tailored LCS eligibility criteria are urgently needed in the growing cancer survivor population.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
M.L. Hsu: Financial Interests, Institutional, Advisory Board: Regeneron, MJH Life Sciences. A. Dowlati: Financial Interests, Institutional, Research Grant: EMD Serono, Tesaro, Roche, Regeneron, Vertex, Eli Lilly, Bayer, Takeda, Ipsen, United Therapeutics, Mirati, Bristol Myers Squibb, Incuron; Financial Interests, Personal and Institutional, Research Grant: AbbVie, AstraZeneca, Millenium, Seattle Genetics; Financial Interests, Personal, Financially compensated role: Ariad. All other authors have declared no conflicts of interest.
Resources from the same session
1726P - Optimizing oncology drug spending in a cancer centre in Ireland
Presenter: Ruth Kieran
Session: Poster session 23
1727P - Barriers and facilitators of physician involvement in clinical oncology database management in Ukraine
Presenter: Inesa Huivaniuk
Session: Poster session 23
1728P - Implementation of a comprehensive oncology unit: Needs detected in cancer survivors during follow-up
Presenter: Francisco J Jimenez-ruiz
Session: Poster session 23
1729P - Targeted interventions in registration and reporting of multidisciplinary team meetings (MDT) in oncology help to improve tumor board decisions
Presenter: Lars Galonska
Session: Poster session 23
1730P - Dealing with digital paralysis: Surviving a cyberattack in a cancer centre
Presenter: Rachel J. Keogh
Session: Poster session 23
1731P - Providing access to anticancer drugs within an armed conflict: The experience of Mission Kharkiv (MK) and Medecins Sans Frontieres (MSF) in Ukraine
Presenter: Stanislav Polozov
Session: Poster session 23
1732P - War and the fragility of anticancer drug supply networks in Ukraine
Presenter: Olha Kostenchak-Svystak
Session: Poster session 23
1733P - Two wars at time: Fight against cancer during war time - experience of Ukraine
Presenter: Veronika Patsko
Session: Poster session 23
1734P - Early impact of a personalized lung cancer interception program for heavy smokers
Presenter: Pamela Abdayem
Session: Poster session 23
1736P - Young adult lung cancer demands more attention in a low-resource area: Bangladesh perspective
Presenter: Muhammad Rafiqul Islam
Session: Poster session 23