ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2024
Pack-Year Smoking History: An Inadequate and Biased Measure to Determine Lung Cancer Screening Eligibility.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Evaluating eight smoking metrics for modelling survival in non-small cell lung cancer.Cancer epidemiology · 2026Pooled it
- Racial inequalities in eligibility and access to lung cancer screening: systematic review of United States studies.BMC public health · 2025Pooled it
- Demographic shifts in referral to and completion of lung cancer screening after the 2021 United States Preventive Services Task Force update.Journal of thoracic disease · 2026Article
- Lung cancer screening disparities among screening-eligible older Black adults with 20 + years of tobacco use: Quantitative findings from a mixed-methods, quasi case-control study.Cancer causes & control : CCC · 2026Article
- Analysis of Lung Cancer Screening Eligibility Among Patients Diagnosed With Lung Cancer: A Retrospective Cohort Study.Journal of the American College of Radiology : JACR · 2026Article
- Screening Eligibility and Survival Among Patients With Lung Cancer in Korea.JAMA network open · 2026Article
- Improving lung cancer screening diagnostic efficiency.Current opinion in pulmonary medicine · 2026Review
- Performance of smoking duration-based lung cancer screening eligibility criteria: a comparative modeling study.Journal of the National Cancer Institute · 2026Article
- Estimating Lung Cancer Screening Eligibility in the Veterans Health Administration Using Patient-Reported Smoking Histories.Journal of general internal medicine · 2026Article
- The landscape of lung cancer screening globally: a comparison of established programs and estimates of eligibility to participate.The Lancet regional health. Western Pacific · 2026Review
- Innovative approaches for lung cancer screening and interception.Nature reviews. Clinical oncology · 2026Review
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- Lung Cancer Screening in the United States, 2024: A National Health Interview Survey Analysis.Chest · 2026Article
- Addressing algorithmic bias in lung cancer screening eligibility.Journal of the National Cancer Institute · 2026Article
- Eligibility and Prognostic Performance of Smoking Duration-Based Versus Pack-Year-Based U.S. National Lung Cancer Screening Criteria Across Racial and Ethnic Groups.Annals of internal medicine · 2026Article
- Bridging the lung cancer screening eligibility gap: evaluation of guideline applicability in asymptomatic patients.Military Medical Research · 2026Observational
- Neglected Occupational Risk Factors-A Contributor to Diagnostic Delays in Lung Cancer.Healthcare (Basel, Switzerland) · 2026Article
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Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
purposePack-year smoking history is an imperfect and biased measure of cumulative tobacco exposure. The use of pack-year smoking history to determine lung cancer screening eligibility in the current US Preventive Services Task Force (USPSTF) guideline may unintentionally exclude many high-risk individuals, especially those from racial and ethnic minority groups. It is unclear whether using a smoking duration cutoff instead of a smoking pack-year cutoff would improve the selection of individuals for screening.
methodsWe analyzed 49,703 individuals with a smoking history from the Southern Community Cohort Study (SCCS) and 22,126 individuals with a smoking history from the Black Women's Health Study (BWHS) to assess eligibility for screening under the USPSTF guideline versus a proposed guideline that replaces the ≥20-pack-year criterion with a ≥20-year smoking duration criterion.
resultsUnder the USPSTF guideline, only 57.6% of Black patients with lung cancer in the SCCS would have qualified for screening, whereas a significantly higher percentage of White patients with lung cancer (74.0%) would have qualified (
conclusionUse of a 20-year smoking duration cutoff instead of a 20-pack-year cutoff greatly increases the proportion of patients with lung cancer who would qualify for screening and eliminates the racial disparity in screening eligibility between Black versus White individuals; smoking duration has the added benefit of being easier to calculate and being a more precise assessment of smoking exposure compared with pack-year smoking history.
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