The Columbus Dispatch

Royal family: Charges taken ‘very seriously’

New guidelines could enable 14.5M to receive testing

- Maria Puente

“The whole family is saddened to learn the full extent of how challengin­g the last few years have been for Harry and Meghan. The issues raised, particular­ly that of race, are concerning.”

Two days after Prince Harry and Duchess Meghan’s shattering interview with Oprah Winfrey, Buckingham Palace issued a four-sentence response, saying their accusation­s of racism and lack of support are taken “very seriously” and will be addressed by the royal family “privately.”

The statement from the palace, issued Tuesday on behalf of Queen Elizabeth II, Harry’s grandmothe­r, arrived by email to USA TODAY after 5:30 p.m. London time (12:30 p.m. Eastern).

“The whole family is saddened to learn the full extent of how challengin­g the last few years have been for Harry and Meghan. The issues raised, particular­ly that of race, are concerning.

“While some recollecti­ons may vary, they are taken very seriously and will be addressed by the family privately. Harry, Meghan and Archie will always be much loved family members.”

The message was typical of palace statements on behalf of the queen: Calm and anything but fulsome.

It was a sharp contrast to the tsunami of media coverage across the globe, but especially in the United Kingdom and America, about the shocking revelation­s

Royal family’s statement

the Duke and Duchess of Sussex made in the interview.

Meghan described feeling so isolated and miserable inside the royal family that she had suicidal thoughts, yet when she asked for mental health help from the palace’s human resources staff she was told she was not a paid employee. She also said a member of the royal family had expressed “concerns” to Harry about the color of her unborn child’s skin.

Prince Charles didn’t comment on the interview Tuesday during a visit to a vaccine clinic in London.

Harry’s father visited a church to see a temporary vaccine clinic in action and met with health care workers, church staff and people due to receive their vaccine jab. The visit was his first public appearance since the interview aired in the U.S. on Sunday night.

Contributi­ng: Associated Press

The U.S. Preventive Services Task Force on Tuesday expanded recommenda­tions for lung cancer screening, which more than doubles the number of U.S. adults eligible for screening, experts say.

The task force made two significant changes to its lung cancer screening: Annual screenings will begin at age 50, instead of 55, and smoking intensity has been reduced from a 30 to a 20 pack-year history. This means patients will eligible if they, for example, smoked one pack a day for 20 years or two packs a day for 10 years.

The inclusive criteria are expected to increase eligibilit­y from 6.4 million adults to 14.5 million, according to an editorial by University of North Carolina School of Medicine professors published in JAMA on Tuesday.

“There’s a huge need to diagnosing patients early,” said Dr. David Carbone, an oncologist and lung cancer specialist at The Ohio State University Comprehens­ive Cancer Center, who is unaffiliated with the editorial. “When you don’t do screening exams, most lung cancer patients are diagnosed when they’re incurable.”

While health experts agree the updated recommenda­tions is a good first step to becoming more inclusive, they also say it doesn’t address the urgent issue of low uptake. Many Americans who are eligible for screening, even by the 2013 standards, still don’t get screened for lung cancer, said Carbone. This is partly due to racial inequities, financial barriers and lack of awareness and education.

People of color who are diagnosed with lung cancer face worse outcomes compared to white Americans partly because they are less likely to be diagnosed early.

Compared to white Americans, Black Americans with lung cancer are 16% less likely to be diagnosed early; Latinos are 13% less likely; and Asian Americans or Pacific Islanders and Native Americans are 14% less likely, according to the American Lung Associatio­n.

Simply expanding the eligibilit­y pool won’t address racial disparitie­s, argues the UNC School of Medicine editorial.

“Implementa­tion will require broader efforts by payers, health systems and profession­al societies, and in the future, a more tailored individual risk prediction approach may be preferable,” said Louise M. Henderson, editorial co-author and professor of radiology at UNC School of Medicine.

Financial barriers could also exacerbate racial disparitie­s. Medicaid is not required to cover the task force’s recommende­d screenings, which could lead to greater inequities if recommenda­tions expand to include more people.

People who receive Medicaid are twice as likely to be smokers than those with private insurance, 26.3% compared with 11.1%, Henderson said, and they are also disproport­ionately affected by lung cancer.

Finally, experts say the screening recommenda­tions won’t do any good for patients at risk for lung cancer if they aren’t aware of them. Most patients eligible for screening are recommende­d by another cancer or pulmonary specialist, or their primary care physician.

As most people don’t regularly visit specialist­s, eligible patients would most benefit from primary care physicians ordering lung cancer screenings, said Dr. Bernard Park, a thoracic cancer surgeon at Memorial Sloan Kettering Cancer Center who heads the lung cancer screening program.

“To be able to order a lung cancer screening test, you have a quick fiveminute discussion with the patient about the risk and benefits, they have to be asymptomat­ic and then they can go off for their scan,” he said.

However, the American Academy of Family Physicians has yet to release updated guidelines for lung cancer screening since recommendi­ng against the practice in 2013. Health experts say primary care physicians may be more encouraged to discuss lung cancer screening if national organizati­ons, such as the AAFP, recommende­d it.

In a statement to USA TODAY, the AAFP said it has been waiting for the task force to include recent studies and trials to its recommenda­tions before releasing its own.

“The AAFP Commission on Health of the Public and Science is conducting a thorough evidence review of the final updated USPSTF recommenda­tion, so it may be several weeks before a final decision is made,” AAFP President Dr. Ada Stewart said in the statement.

 ?? GETTY IMAGES ?? The U.S. Preventive Services Task Force on Tuesday expanded recommenda­tions for lung cancer screening, lowering the eligibilit­y age from 55 to 50 and reducing smoking intensity from a 30 to a 20 pack-year history.
GETTY IMAGES The U.S. Preventive Services Task Force on Tuesday expanded recommenda­tions for lung cancer screening, lowering the eligibilit­y age from 55 to 50 and reducing smoking intensity from a 30 to a 20 pack-year history.

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