• A recent study investigated the impact of including more Black participants in the National Lung Screening Trial (NLST) in order to reduce lung cancer-related deaths.
• The researchers found a relationship between increasing Black participants in a study population and reduced lung cancer-related deaths.
• This study highlights the importance of improving access to lung cancer screening for Black current and former smokers.

A recent study investigated the impact of performing lung cancer screening in a larger population of Black participants. Researchers hope that this study will reduce the overall number of lung cancer deaths in the future and prove the importance of improving access to lung screening for Black people who are current or former smokers.

Lung cancer is the leading cause of cancer-related deaths in the United States, accounting for almost 25 percent of all cancer deaths. However, according to the study, Black people in the U.S. experience the highest rate of death and lowest rates of survival for most cancers. “This statistic is particularly true of lung cancer, with Black men experiencing higher rates of lung cancer death than any other racial or ethnic group,” the study's authors noted.

National Lung Screening Trial

Lung screening can play a critical role in reducing deaths related to lung cancer. Lung cancer is a difficult cancer to diagnose, because the symptoms are often unnoticeable until the disease has progressed to an advanced stage. By this time, the tumors may be large or may have spread to other locations around the body.

Because of this, lung cancer screening is recommended for people ages 50 to 80 years old who have a 20 pack-year smoking history (a pack a day for 30 years), who are currently smoking, or have quit smoking within the past 15 years.

These screening recommendations come from the National Lung Screening Trial. The NSLT, run by the National Cancer Institute, compared two methods of lung screening to determine which method was better at reducing mortality. The randomized clinical trial “demonstrated a 20 percent reduction in lung cancer mortality with annual lung cancer screening using low-dose computed tomography (LDCT) of the chest when compared with chest radiograph (X-ray),” according to the study.

However, among the 53,452 participants in the NLST only 4.3 percent were Black — even though Black people represented 13.4 percent of the U.S. population at the time, according to Census data.

Increasing Proportion of Black Study Participants

The researchers in the new study, which ran from 2002 to 2009, hypothesized that increasing the number of Black participants in the NLST would have changed the outcomes.

In order to test this hypothesis, they created artificial populations that included more Black participants for lung cancer screening. They then used a formula to determine if the screening would reduce overall lung cancer deaths.

For example, in a study population with 13.4 percent Black participants, the reduction in lung cancer-related deaths increased to 18 percent, compared to 16 percent in the original NLST participant population. Based on these findings, the researchers believe lung cancer screening can achieve greater reductions in overall mortality rates than indicated by the National Lung Screening Trial results a decade ago.

According to the authors, their findings highlight “the critical importance of working to improve access to lung cancer screening for Black current and former smokers.”