Aldrich MC, et al. - Via performing a cohort study that included 48,364 adult smokers visiting community health centers across 12 southern US states from March 25, 2002, through September 24, 2009, who were followed for up to 12 years, researchers assessed the diagnostic accuracy of United States Preventive Services Task Force (USPSTF) lung cancer screening eligibility criteria in a predominantly African American and low-income cohort. In African American smokers, the lower percentage of eligible lung cancer cases was principally correlated with fewer smoking pack-years among African Americans vs white smokers. The racial disparity was observed in the sensitivity and specificity of USPSTF guidelines among African American and white smokers for all ages. Reducing the smoking pack-year eligibility criteria to a minimum 20-pack-year history was related to an elevation in the percentage of screening eligibility of African American smokers and with the equitable performance of sensitivity and specificity in contrast with white smokers of all ages. Thus, prevailing USPSTF lung cancer screening guidelines could be too inflexible for African American smokers. The investigators’ findings suggest that race-specific adjustment of pack-year criteria in lung cancer screening guidelines might lead to more evenhanded screening for African American smokers at high risk for lung cancer.