ASPO Abstracts
Evidence of Stage Shift in US Lung Cancer Diagnosis, 2009-2016
Category: Cancer Health Disparities
Conference Year: 2021
Abstract Body:
Purpose: In 2013, the U.S Preventive Services Task Force (USPSTF) began recommending lung cancer
screening for current and past smokers. Lung cancer screening may lower lung cancer-related deaths, but
attendance may not be consistent across smokers from different races or geography. In this study, we
investigate if the implementation of the USPSTF guidelines resulted in a shift toward earlier stages at diagnosis
(stage shift) by race and geographical regions.
Methods: Using data from the Surveillance, Epidemiology, and End Results (SEER) for lung cancers
diagnosed 2009 to 2016, we calculated and compared annual proportions of early and late stage diagnoses
before and after 2013, stratified by patient race, and SEER geographical regions.
Results: In the Northeast region from 2009 to 2012, Whites had low percentage margins in comparison to
Blacks (1.28% increase in Whites vs 8.35% decrease in Blacks). From 2013 to 2016, Whites in the Northeast
experienced higher proportions of early stage diagnoses in comparison to Blacks(15.26% increase vs 10.96%
increase, respectively). In the Southeast region, Whites initially had lower proportional changes from 2009 to
2012 in comparison to Blacks (1.66% increase vs. 5.28% decrease, respectively) and from 2013 to 2016,
Blacks experienced higher proportions in comparison to Whites who had similar proportions in the early stage.
(7.55% increase in Whites vs 18.57% in Blacks) However, Blacks continued to experience higher proportions
of patients diagnosed in later-stage diagnosis in comparison to Whites as seen in early-stage lung cancer
diagnosis.
Conclusions: Lung cancer diagnosis has been decreasing over time, and stage shift is evident in some
populations, however not uniformly by race and geographical regions. Blacks are still more likely to be
diagnosed at a later-stage in comparison to Whites, pointing to problems with uptake of screening guidelines.
Keywords: cancer, screening, disparities, African Americans