Lung cancer is the leading cause of cancer related deaths in the United States with an estimate of over 200,000 new cases and 135,720 deaths in 2020. Despite the development of precision therapies, immunotherapy and improved surgical techniques, the overall 5-year survival has remained below that of many other malignancies and significant disparities continue to persist. Black American males tend to present with later-stage disease, are less likely to undergo appropriate staging and thus, have a higher lung cancer mortality. The National Lung Screening Trial I (NLST) determined that low-dose CT (LDCT) screening could reduce lung cancer specific mortality by nearly 20% and overall mortality by 6.7%. However, studies suggest that clinically useful models for improved lung cancer risk stratification will be essential to the identification of those most likely to benefit from screening while minimizing unnecessary screening and associated risks. In NLST, only 4% of enrolled participants were Black Americans. Recent investigation demonstrates that current screening eligibility criteria are insufficient in identifying Black Americans at risk for lung cancer a large percentage of whom are diagnosed at a younger age than White Americans and with less tobacco consumption. As a result, current draft recommendations include reducing both age and smoking screening eligibility to 50 years of age and 20 pack years respectively with a goal of narrowing gaps in disparities in early lung cancer diagnosis and outcome. Here, we will review current models for lung cancer risk stratification that incorporate sociodemographic factors, comorbid illnesses and non-invasive biomarkers and discuss their clinical application to diverse populations.

Citation Format: Patrick Nana-Sinkam. Lung Cancer Risk Assessment in Diverse Populations: One Size Cannot Fit All [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr IA16.