Dr Ajay Sheshadri Emphasizes the Necessity of Obtaining Updated Data for Lung Cancer Screening Guidelines

Ajay Sheshadri, MD, MSCI, associate professor of pulmonary medicine at the University of Texas MD Anderson Cancer Center, says that lung screening improvements and the implementation of race-neutral guidelines are crucial to keep in mind for future progress in pulmonary health.

Transcript

What do you hope will happen between CHEST 2023 and CHEST 2024 in terms of how disparities in lung health care are addressed?

There's a lot of things that need to improve. I don't know how many of them will improve in the span of 1 year; I think this is more of like a 10-year or even longer project. But it needs to improve sooner than later. Some of the specific things that I'd like to improve in the short term, are the access to lung cancer screening. In general, the amount of engagement that our population has with lung cancer screening is very, very low, and it's one of the most effective forms of cancer screening that we have. I'm hoping that some of the disparities that we have in engagement that are along, for example, racial lines or socioeconomic lines will be reduced over time and this screening will become more available.

I'm also hopeful that we'll improve access to cancer centers up front. I think there's a delay in getting cancer care, which impacts what we're able to do. That includes some folks presenting with a later stage, where some of the options that might have been available to us at earlier stage are no longer available. Of course, that feeds a little bit on more effective and more available screening.

Finally, from just a personal perspective, I hope we are able to implement race-neutral guidelines, but also take a critical reexamination of the existing data to understand what are the actual thresholds using race-neutral guidelines that dictate whether someone is at low, medium, or high risk for pulmonary complications? That's something that may require more time for us to collect new data. These data probably needs to be collected anyway, because some of the data that influenced the recommendations that have been made are many, many years old.

And so, I think it's time for us to understand what the true risk is with modern surgical techniques and do it with this lens of looking at everybody without applying race corrections to their lung function values.