USPSTF Lung Cancer Screening Criteria May Be Missing Women

Research presented at the CHEST Annual Meeting 2019 found that current lung cancer screening guidelines are insufficient to capture the majority of women with lung cancer.

Current U.S. Preventive Services Task Force (USPSTF) guidelines use age and smoking history as prerequisites for lung cancer screening, but 20% of lung cancers are not attributed to tobacco. Thus, there may be a gender gap in lung cancer mortality.

In a retrospective cohort study, researchers conducted a chart review of 294 female patients treated for lung cancer between 2005 and 2015 at the Los Angeles County Hospital and Norris Comprehensive Cancer Center. They assessed demographics (e.g., age, sex, ethnicity), smoking status, family history, and lung cancer subtype.

Many women (n=237; 80.6%) did not meet the USPSTF lung cancer screening criteria at the time of diagnosis, most commonly because they were younger (27.4%) and smoked less than 30 pack-years (75.1%).

The researchers noticed that race may also play a role, as 37.5% were Asian and 28.0% were Hispanic, and “these ethnicities tend to have non-smoking lung cancer with genomic mutations,” they noted. Many women (83.5%) who did not meet the USPSTF criteria had lung cancers that were adenocarcinoma in histology, and nearly half (48.1%) had a family history of malignancy.

“The mortality trends of female lung cancer in the United States will not improve until more research is done and low-dose chest computed tomography screening criteria is revised,” the authors concluded.


Vu C, Lin S, Chang CF. Gender gaps in care: lung cancer screening criteria in women. Presented at the CHEST Annual Meeting 2019. October 19-23, 2019; New Orleans, Louisiana.