Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida.
Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida.
Cancer Epidemiol Biomarkers Prev. 2019 May;28(5):963-973. doi: 10.1158/1055-9965.EPI-18-0629.
Many professional societies published guidelines recommending lung cancer screening with low-dose CT scan. We examined the temporal trends in patient-reported physician-patient discussions about lung cancer screening, and aimed to determine the association of discussions of lung cancer screening with the smokers' attempt to quit and intent to quit.
Data from years 2012, 2014, and 2017 of the National Cancer Institute's Health Information National Trends Survey (HINTS) were combined to create a multiple-year analytic dataset. We calculated the association between samples' characteristics and the presence of discussion about lung cancer screening. Using logistic regression, we estimated the probability of smokers' attempt to quit and intent to quit.
Among 9,443 subjects, the crude estimated rates of physician-patient discussion decreased from 6.7% in 2012, to 4.2% in 2014 and 4.3% in 2017. Across the age and smoking status groups, the current smokers ages 55 to 74 in 2012 (26.8%), and current smokers older than 74 years in 2014 (23.5%) and 2017 (22.1%) had the highest rates of discussion. The physician-patient discussion about lung cancer screening was not associated with patients' intent to quit or attempt to quit in a multivariable analysis. Efforts are needed to improve the physician-patient discussion about lung cancer screening among individuals across a spectrum of lung cancer risk.
Developing communication strategies for promoting beneficial lung cancer screening among lung cancer screening-eligible smokers and strategies for improving the quality of discussion on lung cancer screening integrating smoking cessation are needed to reduce the burden of lung cancer.
许多专业学会发布了使用低剂量 CT 扫描进行肺癌筛查的指南。我们研究了患者与医生就肺癌筛查进行讨论的时间趋势，并旨在确定讨论肺癌筛查与吸烟者戒烟尝试和戒烟意愿之间的关系。
将美国国立癌症研究所健康信息全国趋势调查（HINTS）2012、2014 和 2017 年的数据合并到一个多年分析数据集。我们计算了样本特征与肺癌筛查讨论之间存在的相关性。使用逻辑回归，我们估计了吸烟者戒烟尝试和戒烟意愿的概率。
在 9443 名受试者中，医生与患者讨论肺癌筛查的未调整估计率从 2012 年的 6.7%下降到 2014 年的 4.2%和 2017 年的 4.3%。在年龄和吸烟状况组中，2012 年 55 岁至 74 岁的当前吸烟者（26.8%）、2014 年和 2017 年年龄超过 74 岁的当前吸烟者（23.5%和 22.1%）的讨论率最高。多变量分析显示，肺癌筛查的医患讨论与患者的戒烟意愿或戒烟尝试无关。需要努力改善各种肺癌风险个体的肺癌筛查医患讨论。
需要制定沟通策略，以促进肺癌筛查合格吸烟者进行有益的肺癌筛查，并制定改善肺癌筛查讨论质量的策略，将戒烟纳入其中，以减轻肺癌负担。
