Timothy Murphy, MD, FACP, current practice president at Rocky Mountain Cancer Centers, spoke with The American Journal of Managed Care® about the current state of lung cancer screenings.
Timothy Murphy, MD, FACP, practice president for Rocky Mountain Cancer Centers (RMCC), discusses racial disparities in lung cancer screening and what practices can do to improve screenings.
How are changes in lung cancer screening guidelines helping to reduce racial disparities?
Lung cancer screening became approved in 2013, based mostly on the fact that lung cancer is the second most common cancer but also the one cancer with the highest mortality. So, 2 national trials were published and lung cancer screening became approved.
The screening population, defining the high-risk population, was defined as the duration of smoking and age of the patient. Those guidelines got revised in 2021 when it became apparent that there were racial disparities in the screening populations between the different ethnic groups. So in 2021, they lowered the screening age from age 55 down to 50. But they also lowered what's considered the high-risk smoking group from 30 pack-years down to 20 pack-years. The hope there was that that would alleviate some of the disparities, because we know, different from the Caucasian population, that [the] African American population tends to develop lung cancer at an earlier age, and maybe even with a lower amount of smoking exposure.
So those changes were made, and there have been some very recent reports showing that although that improved the rate of screening in the minority populations, it has not alleviated that discrepancy. This story hasn't been fully written yet. There are many more variables that need to be looked at in order to reach out to the minority populations and increase their screening rates. We know there are residential constraints for some minority populations in their ability to go in and physically get screened. There are differences in insurance coverage. So there are a lot more barriers than just defining the high-risk group with their smoking history and/or age.
How can practices like Rocky Mountain Cancer Centers work with primary care to improve cancer screenings?
So [for] RMCC, to screen the population is going to be a team-wide approach. RMCC is just one of the players that can help increase screening capability. And we're already doing this in many communities. As a leader in community cancer care in Colorado, we work very closely with our current primary care base in the different neighborhoods that we have presence. But it's going to take more than just working with primary care. It's going to take advocacy at the local grassroots level. It will take education. It will take probably government investment to increase screening rates throughout the state of Colorado.