Mongan Institute, Clinical and Translational Epidemiology Unit, Massachusetts General Hospital Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA.
Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Dana-Farber Cancer Institute at St. Elizabeth's Medical Center, Boston, MA, USA.
Prev Med. 2019 Jul;124:84-90. doi: 10.1016/j.ypmed.2019.05.001. Epub 2019 May 2.
Despite demonstrated reduction in lung cancer mortality, lung cancer screening uptake has been low. We investigated differences in discussions with physicians about lung cancer screening and awareness using repeated cross-sectional data from three cycles [4.2 (2013); 4.4(2014) and 5.1 (2017)] of the Health Information National Trends Survey. We included 4207 respondents age 55 to 80 who responded to this question: 'In the past year, have you talked with your doctor about having a test to check for lung cancer?'. We used logistic regression accounting for complex sample weighting to generate multivariable adjusted odds ratios (ORs) and 95% confidence intervals (CIs). The proportion of participants reporting lung cancer screening discussions was low and did not increase over time. In the most recent cycle, 15.7% of current smokers and 9.9% of former smokers said they had discussed screening. Compared to males, females were 32% less likely to report a lung cancer screening discussion (OR: 0.68, 95% CI: 0.50-0.93) and the association was strongest among non-Hispanic White females. Estimates were similar among never (OR: 0.72, 95% CI: 0.43-1.20), current (OR: 0.73, 95% CI: 0.39-1.36), and former (OR: 0.66, 95% CI: 0.40-1.10) smokers. Females were 32% less likely than males to be aware of a lung cancer screening test (OR: 0.68, 95% CI: 0.47-0.99) and this association was strongest for non-Hispanic Black females (OR: 0.38, 95% CI: 0.19-0.77). Too few providers have discussed lung cancer screening with potentially eligible patients, particularly female patients. Further research is needed to evaluate possible causes for this finding.
尽管肺癌死亡率已明显降低，但肺癌筛查的参与率仍较低。我们利用健康信息国家趋势调查（Health Information National Trends Survey）三个周期[2013 年的第 4.2 轮（4.2）；2014 年的第 4.4 轮（4.4）和 2017 年的第 5.1 轮（5.1）]的重复横断面数据，调查了与医生讨论肺癌筛查和意识方面的差异。我们纳入了 4207 名年龄在 55 岁至 80 岁之间的受访者，他们回答了这个问题：“在过去的一年中，您是否与医生讨论过进行肺癌检查的测试？”。我们使用考虑到复杂样本权重的逻辑回归生成多变量调整后的优势比（OR）和 95%置信区间（CI）。报告肺癌筛查讨论的参与者比例较低，且并未随时间增加。在最近的周期中，15.7%的当前吸烟者和 9.9%的前吸烟者表示曾讨论过筛查。与男性相比，女性报告肺癌筛查讨论的可能性低 32%（OR：0.68，95%CI：0.50-0.93），并且这种关联在非西班牙裔白种女性中最强。从不吸烟（OR：0.72，95%CI：0.43-1.20）、当前吸烟（OR：0.73，95%CI：0.39-1.36）和前吸烟（OR：0.66，95%CI：0.40-1.10）的女性中，估计值相似。女性对肺癌筛查测试的认知度比男性低 32%（OR：0.68，95%CI：0.47-0.99），并且这种关联在非西班牙裔黑种女性中最强（OR：0.38，95%CI：0.19-0.77）。与男性相比，太少的提供者与潜在合格患者，特别是女性患者，讨论了肺癌筛查。需要进一步研究以评估这种发现的可能原因。
