Department of Respiratory Medicine, St Vincent's University Hospital, Dublin, Ireland.
Lung. 2012 Dec;190(6):621-8. doi: 10.1007/s00408-012-9421-9. Epub 2012 Oct 12.
The National Lung Screening Trial (NLST) has renewed interest in low-dose computed tomography (LDCT) screening for lung cancer. Smokers may be less receptive toward LDCT screening, however, compared with never smokers. The views of patients with COPD, a particularly high-risk group, toward LDCT screening for lung cancer are currently unknown. We therefore evaluated attitudes of patients with COPD toward LDCT screening for lung cancer.
Interviews with Irish patients with COPD who satisfied NLST eligibility criteria were conducted in clinical settings using a questionnaire based on that of a comparable study of U.S. current/former smokers of unspecified disease status.
A total of 142 subjects had a mean age of 65.09 ± 6.07 years (46.4 % were male, mean pack years 54.5 ± 33.3, mean FEV1 59.16 ± 23 %); 97.8 % had an identifiable usual source of healthcare. Compared with data from a U.S. cohort of current/former smokers, a higher proportion of Irish COPD smokers: believed that they were at risk for lung cancer (63.6 vs. 15.7 %); believed that early detection improved chances of survival (90 vs. 51.2 ); were willing to consider LDCT screening (97.9 vs. 78.6 %); were willing to pay for a LDCT scan (68.6 vs. 36.2 %); and were willing to accept treatment recommendations arising (95.7 vs. 56.2 %; p < 0.0001 for all comparisons).
Urban Irish smokers with COPD who would be eligible for LDCT screening are almost universally in favor of being screened and treated for screening-detected lung cancers. This readily accessible high-risk population should be actively targeted in future screening programs.
国家肺癌筛查试验（NLST）重新引发了人们对低剂量计算机断层扫描（LDCT）筛查肺癌的兴趣。然而，与从不吸烟者相比，吸烟者对 LDCT 筛查的接受程度可能较低。目前尚不清楚 COPD 患者（一个特别高风险群体）对 LDCT 筛查肺癌的看法。因此，我们评估了 COPD 患者对 LDCT 筛查肺癌的态度。
在临床环境中，使用基于美国目前/以前患有未指明疾病状态的吸烟者的类似研究的问卷，对符合 NLST 入选标准的爱尔兰 COPD 患者进行了访谈。
共有 142 名患者的平均年龄为 65.09 ± 6.07 岁（46.4%为男性，平均吸烟量为 54.5 ± 33.3，FEV1 平均值为 59.16 ± 23%）；97.8%有可识别的常规医疗来源。与美国目前/以前吸烟者队列的数据相比，爱尔兰 COPD 吸烟者中有更高比例的人：认为自己有患肺癌的风险（63.6%比 15.7%）；认为早期检测提高了生存机会（90%比 51.2%）；愿意考虑 LDCT 筛查（97.9%比 78.6%）；愿意支付 LDCT 扫描费用（68.6%比 36.2%）；并愿意接受由此产生的治疗建议（95.7%比 56.2%；所有比较均 p<0.0001）。
符合 LDCT 筛查条件的爱尔兰城市吸烟者几乎普遍赞成对其进行筛查和治疗筛查发现的肺癌。在未来的筛查计划中，应该积极针对这个容易接触到的高危人群。
