Editorials 1755 been a shift of the peak age at presentation to patients over the age of 40 years, especially among women. The explanation for this “delay” in presentation is unknown. The investigators report that only lung involvement was independent of age, sex, and race. However, they did not perform further analysis of pulmonary disease severity based on age, sex, and race. Sarcoidosis is reported to be more severe in African Americans, whereas white individuals are more likely to present with asymptomatic disease (1, 5). In addition, extrathoracic manifestations are said to be more common in certain populations, such as chronic uveitis in African Americans, lupus pernio in Puerto Ricans, and erythema nodosum in Europeans (1, 5). In the current study, extrathoracic lymphadenopathy, eye, liver, skin (other than erythema nodosum), and bone marrow involvement were more common in African Americans. Abnormal calcium metabolism (hypercalciuria or hypercalcemia) was more frequent in white individuals and in subjects older than 40 years of age. The frequency of erythema nodosum was higher in women but did not differ by race. Extrathoracic lymphadenopathy was more frequent in those individuals younger than 40 years of age. The importance of the ACCESS Study in determining the etiology of sarcoidosis is obvious. The preliminary analysis of the subjects enrolled in the study shows that this is a potentially representative, though not ideal, cohort to study. The assessment instrument developed by this group appears useful and needs to be validated. If validated it may provide a robust instrument to standardize the identification of organ involvement and thus provide a method to monitor the course of the disease.