Lung Cancer Screening Must Address Disparities in AAPI Women: Tabby Khan, MD, MPH

Seventy percent of Asian American and Pacific Islander women had non- or never-smoking lung cancer in a recent analysis from Komodo Health. Tabby Khan, MD, MPH, senior director of analytics at Komodo Health, called for increased screening measures and criteria to address underreported populations like AAPI women, who are more susceptible due to genetic mutations and environmental factors.

Transcript

What kind of partnerships or outreach does Komodo pursue to ensure these insights reach advocacy groups, health systems, or regulators who can act on them?

I mentioned I work with the CDC and the Cancer Moonshot, as well as Fight Colorectal Cancer. We also have worked closely with the Allergy and Asthma Foundation of America and the Chan Zuckerberg Initiative's Rare As One Network. And then there are so many others that I like; I don't even know where to begin. We've partnered with so many different advocacy groups, but basically from defining rare diseases, identifying patients earlier and helping patients find and educate providers to improve clinical trial recruitment. We have helped so many different types of organizations, addressingsome of the biggest challenges that patients face as they navigate their healthcare journeys.

I'm a big fan of just learning from the data, and I think that being here has really shown me that we have such a powerful data set. And now that we've kind of brought in some AI tools to even streamline that even more, we're able to drive these insights and provide support to advocacy groups and government organizations, as well as our life sciences colleagues who are really working on developing those drugs and making sure they get in the hands of the right people. But we also want to give access to our healthcare map to a variety of others, whether it's life sciences, companies, advocacy groups, etc., to do this.

One thing that we did is we actually partnered with the Robert Wood Johnson Foundation, and we awarded recipients of their 2024 diet-related grant free access to Komodo's healthcare map to really study the impact of diet on health. And we offered kind of consultancy from our various teams to really define patient populations. But lung cancer is not the only disease area that we're interested in. We've done analysis on a variety of different kinds of women's health areas. We've looked at specific drugs and making sure that they're reaching the right patient populations.

When I first started at Komodo—I've been here for 5 years, which feels like a long time, but every day I learn something new—we actually were some of the first people to publish on the overall impact of what COVID was doing to the healthcare landscape. We were able to quantify that we're seeing colonoscopies go down, mammograms go down, and routine lab screenings. So really having all of those insights at our fingertips has been really useful.

Given that lung cancer screening guidelines are still largely tied to smoking history, how can insights like these drive equity-centered updates to screening eligibility?

I think that changing screening guidelines is a long process, right? There needs to be a ton of really judicious research. We need to go back to that whole, "How do we balance things like radiation exposure and health care utilization with actually identifying patients who are highly at risk for certain diseases. I want to just kind of go back to those 2 key pillars of provider education and patient advocacy. Provider education is using these types of studies that are done on large data sets that are quite diverse and include men and women, non-binary people, that include Black patients, Asian patients, Hispanic and Latino patients, as well as white patients, as well as mixed-race populations who aren't studied quite as frequently. And just making sure that they know, hey, this may present a little bit differently in this population.

My family's South Asian, and one thing I always grew up hearing about was how South Asian people are more at risk for heart disease, even if they're at a healthy weight. And I've read articles now that kind of quantify that and really show that. And it's something that I think would be really interesting to look at in a large database. But only when providers are educated with that information, are they going to be able to ask those pointed questions when a patient shows up at the ER or at their annual physical. And they say, “Hey, you have a little bit of a nagging cough, and you've had this environmental exposure. Maybe this is something that we should kind of follow up on little bit more judiciously.”

And then I think patients’ individual life is busy. They're not always going to be able to advocate. There’s also, in certain populations, a hesitancy to advocate for oneself within hospital visits or the medical community, but we need to kind of work with these advocacy partners and, just by publishing articles like this, empower patients with information that can help them drive somewhat of their own healthcare journey as well.