Nadpara Pramit A, Madhavan S Suresh, Tworek Cindy
W V Med J. 2016 Sep-Oct;112(5):66-71.
Tobacco-use is common among elderly lung cancer patients and continued tobacco-use can impact prognosis. This study evaluates patterns of receipt of Tobacco-use Cessation Counseling (TCC) services among these patients.
Using West Virginia Cancer Registry-Medicare linked database (2004-2007), we identified elderly patients with lung cancer (n = 922) and categorized them by receipt of TCC services. Hierarchical generalized logistic model was constructed and survival outcomes were analyzed by Kaplan-Meier analysis, Log-Rank test, and Cox proportional hazards modeling.
Majority of patients (76.7%) received TCC services. Unadjusted analysis showed favorable survival outcomes in patients who received TCC services. However, adjusted lung cancer mortality risk was no different between the groups (HR (95% CI) = 1.78 (0.87-3.64)).
This study highlights the critical need to address disparities in receipt of TCC services among elderly. Although lung cancer preventive services are covered under the Medicare program, underutilization of these services is a concern.
烟草使用在老年肺癌患者中很常见，持续吸烟会影响预后。本研究评估了这些患者接受戒烟咨询（TCC）服务的模式。
利用西弗吉尼亚癌症登记处与医疗保险关联的数据库（2004 - 2007年），我们确定了老年肺癌患者（n = 922），并根据他们接受TCC服务的情况进行分类。构建了分层广义逻辑模型，并通过Kaplan - Meier分析、对数秩检验和Cox比例风险模型分析生存结果。
大多数患者（76.7%）接受了TCC服务。未调整分析显示，接受TCC服务的患者生存结果较好。然而，两组之间调整后的肺癌死亡风险没有差异（HR（95%CI）= 1.78（0.87 - 3.64））。
本研究强调了解决老年人在接受TCC服务方面差异的迫切需求。尽管医疗保险计划涵盖了肺癌预防服务，但这些服务的利用不足令人担忧。
