Medics are missing cases of emphysema among Black men in the US because medical tests make race-based assumptions about the way healthy lungs function
Black men in the US who are in their fifties may be more than six times more likely than white men of the same age to have emphysema when lung function tests deem them to have better-than-normal lung function. The findings highlight the need to“It was surprising to see these considerable rates of emphysema in Black men who we would consider to have above normal lung function,” saidat Northwestern University in Chicago.
Emphysema is an irreversible condition in which tiny air sacs – called alveoli – in the lungs are damaged by toxic chemicals from smoking and air pollution, causing shortness of breath. Diagnosis involves tests that assess a person’s ability to inhale and exhale, and current treatments provide symptom-relief through drugs that expand the airways.
They found that 12.2 per cent of Black men who were classed as having above normal lung function in 2015 actually had emphysema, which showed up clearly in the lung images taken in 2010. In contrast, just 2 per cent of white men who were classed as having above normal lung function in 2015 actually had emphysema.
“Since emphysema is irreversible, our study probably underestimates the number of emphysema cases that would be missed according to lung function tests, given the five year gap between visible signs of emphysema in the lung images and the lung function tests,” says Liu. The team then removed the race-based adjustments applied to the lung test data collected in 2015. Doing so removed the problem: no Black men with emphysema were incorrectly classed as having above normal lung function. The researchers presented their work at the“I think the evidence shows we really need to stop using race-adjustments in lung tests. Over the past few years the evidence is growing – they are contributing to racial disparities in healthcare,” says Liu.
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