Grant Details
Grant Number: |
5R01CA251758-03 Interpret this number |
Primary Investigator: |
Aldrich, Melinda |
Organization: |
Vanderbilt University Medical Center |
Project Title: |
Addressing Racial Disparities in Lung Cancer Screening |
Fiscal Year: |
2023 |
Abstract
PROJECT SUMMARY/ABSTRACT
Screening promotes early detection of cancer to decrease mortality. Unfortunately, significant racial disparities
exist in lung cancer screening. Recently published findings by our team show that under current national
screening guidelines African Americans have reduced eligibility for lung cancer screening compared to whites.
These screening guidelines are based on a combination of age and smoking pack-year criteria derived from a
national lung screening trial that was primarily (91%) white. Importantly, smoking behaviors and baseline risks
for lung cancer differ greatly between African Americans and whites. Because of this, a risk-based screening
strategy may provide a more equitable assessment of eligibility than current screening guidelines. However, the
development of personalized risk prediction models for lung cancer in African Americans has been limited. To
address this gap and to improve equity in screening eligibility, we propose building a personalized prediction tool
using the combined data from three large-scale population-based prospective cohorts with substantial African
American representation. The combined cohorts have over 336,000 individuals (44% African American) and
9,132 incident lung cancer cases from across the United States. We propose the following three aims: 1)
construct a well-calibrated natural-history model of lung cancer risk for screening in African Americans, 2)
evaluate lung cancer screening strategies by simulation and identify sub-populations who would benefit from
screening, accounting for comorbidities and false-positives, and 3) develop a web-based decision aid for
screening that is culturally appropriate. We will employ innovative machine learning techniques and state-of-the-
art statistical methods to build a well-calibrated lung cancer prediction model for African Americans. Careful
examination will identify sub-populations (such as women, low socioeconomic status, rural, age groups, etc.)
that will benefit from screening. A key innovative aspect of this proposal is its community-engaged approach and
partnership with a Community Advisory Board, both of which will help translate our empirical findings into the
design of a patient-oriented decision aid. This project is relevant to the mission of the National Cancer Institute
since it focuses on establishing equity in lung cancer screening eligibility. Our findings will have sustained impact
on precision health and motivate improved clinical strategies for the early detection of lung cancer for African
Americans.
Publications
Germline prediction of immune checkpoint inhibitor discontinuation for immune-related adverse events.
Authors: Middha P.
, Thummalapalli R.
, Quandt Z.
, Balaratnam K.
, Cardenas E.
, Falcon C.J.
, Princess Margaret Lung Group
, Gubens M.A.
, Huntsman S.
, Khan K.
, et al.
.
Source: Medrxiv : The Preprint Server For Health Sciences, 2024-06-11 00:00:00.0; , .
EPub date: 2024-06-11 00:00:00.0.
PMID: 38947092
Related Citations
Patient Lung Cancer Screening Decisions and Environmental and Psychosocial Factors.
Authors: Richmond J.
, Fernandez J.R.
, Bonnet K.
, Sellers A.
, Schlundt D.G.
, Forde A.T.
, Wilkins C.H.
, Aldrich M.C.
.
Source: Jama Network Open, 2024-05-01 00:00:00.0; 7(5), p. e2412880.
EPub date: 2024-05-01 00:00:00.0.
PMID: 38819825
Related Citations
Interaction between Continuous Pack-Years Smoked and Polygenic Risk Score on Lung Cancer Risk: Prospective Results from the Framingham Heart Study.
Authors: Duncan M.S.
, Diaz-Zabala H.
, Jaworski J.
, Tindle H.A.
, Greevy R.A.
, Lipworth L.
, Hung R.J.
, Freiberg M.S.
, Aldrich M.C.
.
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2024-04-03 00:00:00.0; 33(4), p. 500-508.
PMID: 38227004
Related Citations
Polygenic risk score for ulcerative colitis predicts immune checkpoint inhibitor-mediated colitis.
Authors: Middha P.
, Thummalapalli R.
, Betti M.J.
, Yao L.
, Quandt Z.
, Balaratnam K.
, Bejan C.A.
, Cardenas E.
, Falcon C.J.
, Faleck D.M.
, et al.
.
Source: Nature Communications, 2024-03-26 00:00:00.0; 15(1), p. 2568.
EPub date: 2024-03-26 00:00:00.0.
PMID: 38531883
Related Citations
The Thoracic Research Evaluation and Treatment 2.0 Model: A Lung Cancer Prediction Model for Indeterminate Nodules Referred for Specialist Evaluation.
Authors: Godfrey C.M.
, Shipe M.E.
, Welty V.F.
, Maiga A.W.
, Aldrich M.C.
, Montgomery C.
, Crockett J.
, Vaszar L.T.
, Regis S.
, Isbell J.M.
, et al.
.
Source: Chest, 2023 Nov; 164(5), p. 1305-1314.
EPub date: 2023-06-17 00:00:00.0.
PMID: 37421973
Related Citations
Genetic prediction of colitis in non-small cell lung cancer patients on immune checkpoint inhibitor therapy.
Authors: Middha P.
, Thummalapalli R.
, Betti M.J.
, Quandt Z.
, Balaratnam K.
, Cardenas E.
, Falcon C.J.
, Faleck D.M.
, Princess Margaret Lung Group
, Gubens M.A.
, et al.
.
Source: Medrxiv : The Preprint Server For Health Sciences, 2023-05-16 00:00:00.0; , .
EPub date: 2023-05-16 00:00:00.0.
PMID: 37292751
Related Citations
Racial Disparities in Lung Cancer Stage of Diagnosis Among Adults Living in the Southeastern United States.
Authors: Richmond J.
, Murray M.H.
, Milder C.M.
, Blume J.D.
, Aldrich M.C.
.
Source: Chest, 2022-11-24 00:00:00.0; , .
EPub date: 2022-11-24 00:00:00.0.
PMID: 36435265
Related Citations
Design and methodological considerations for biomarker discovery and validation in the Integrative Analysis of Lung Cancer Etiology and Risk (INTEGRAL) Program.
Authors: Robbins H.A.
, Alcala K.
, Moez E.K.
, Guida F.
, Thomas S.
, Zahed H.
, Warkentin M.T.
, Smith-Byrne K.
, Brhane Y.
, Muller D.
, et al.
.
Source: Annals Of Epidemiology, 2022-10-29 00:00:00.0; 77, p. 1-12.
EPub date: 2022-10-29 00:00:00.0.
PMID: 36404465
Related Citations
Psychosocial impact of COVID-19 among adults in the southeastern United States.
Authors: Richmond J.
, Sanderson M.
, Shrubsole M.J.
, Holowatyj A.N.
, Schlundt D.G.
, Aldrich M.C.
.
Source: Preventive Medicine, 2022-08-11 00:00:00.0; , p. 107191.
EPub date: 2022-08-11 00:00:00.0.
PMID: 35964774
Related Citations