The USPSTF 2021 lung cancer screening criteria left 40.9% (95% CI 31.9-50.5%) of diagnosed lung cancer cases ineligible for screening, compared to 57.6% under the 2013 criteria.
Meta-Analysis (n=20,313)
Over 40% of patients diagnosed with lung cancer remain ineligible for screening under current USPSTF 2021 criteria, primarily due to insufficient smoking pack-years, highlighting the need for alternative risk-based screening strategies.
Absolute Event Rate: 40.9% vs 57.6%
10573 Background: Lung cancer (LC) screening utilizes low-dose CT recommended by the US Preventive Services Task Force (USPSTF) based on age and smoking history. However, the proportion of patients who develop LC but are ineligible for screening at diagnosis remains unclear. We performed a meta-analysis to quantify the burden of LCs missed under USPSTF 2013 and 2021 criteria and identify key reasons for ineligibility. Methods: We systematically searched PubMed, Embase, and Scopus to identify studies reporting USPSTF screening eligibility among adults diagnosed with primary LC who ever smoked. Data were pooled using random-effects models. Primary outcomes included pooled proportions (PP) of LC cases ineligible for USPSTF screening using 2013 and 2021 criteria. Secondary analyses evaluated reasons for ineligibility, including age, smoking pack-years (yrs), and quit-yrs. Statistical significance is defined as p 80 yrs) 34.7% (28.2-41.8) 70 Insufficient pack-yrs (15 yrs) 25.8% (10.8-49.8) 97 USPSTF 2021 Criteria Overall Ineligibility 40.9% (31.9-50.5) 98 Age-based exclusion (80) 31.8% (18.4-49.0) 96 Insufficient pack-yrs (15 yrs) 49.6% (37.1-62.0) 94
Qidwai et al. (Wed,) conducted a meta-analysis in Lung cancer (n=20,313). USPSTF 2021 screening criteria vs. USPSTF 2013 screening criteria was evaluated on Pooled proportion of lung cancer cases ineligible for USPSTF screening (95% CI 31.9-50.5). The USPSTF 2021 lung cancer screening criteria left 40.9% (95% CI 31.9-50.5%) of diagnosed lung cancer cases ineligible for screening, compared to 57.6% under the 2013 criteria.