Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Department of Medicine, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave., 2nd Floor, New York, NY, 10017, USA.
Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA.
J Cancer Educ. 2022 Jun;37(3):631-640. doi: 10.1007/s13187-020-01857-4.
Racial/ethnic minorities face stark inequalities in lung cancer incidence, treatment, survival, and mortality compared with US born non-Hispanic Whites. Lung cancer screening (LCS) with low-dose computed tomography (LDCT) is effective at reducing lung cancer mortality in high-risk current and former smokers and is recommended by the US Preventive Services Task Force (USPSTF). This study sought to assess primary care providers' (PCPs') knowledge, attitudes, beliefs, and practice related to LCS and the recent USPSTF guidelines in five high-risk immigrant communities in New York City. We surveyed 83 eligible PCPs between December 2016 and January 2018 through surveys sent by mail, email, and fax, administered by phone or in person. The survey included questions about providers' clinical practice, knowledge, attitudes, and beliefs related to LCS and the USPSTF guidelines. Information about patient demographics, PCPs' training background, and practice type were also collected. Sixty-seven percent of respondents reported that they did not have established guidelines for LCS at their practice, and 52% expressed that "vague" screening criteria influenced their referral processes for LCS. Barriers to LCS with LDCT included concerns that LDCT is not covered by insurance, patients' fears of screening results, and patients' concerns regarding radiation exposure. Targeted educational interventions for both PCPs and patients may increase access to recommended LCS, especially for populations at disproportionate risk for lung cancer.
与美国出生的非西班牙裔白人相比，少数族裔在肺癌发病率、治疗、生存和死亡率方面面临明显的不平等。低剂量计算机断层扫描 (LDCT) 肺癌筛查 (LCS) 可有效降低高危现吸烟者和前吸烟者的肺癌死亡率，并被美国预防服务工作组 (USPSTF) 推荐。本研究旨在评估纽约市五个高危移民社区的初级保健提供者 (PCP) 与 LCS 及最近的 USPSTF 指南相关的知识、态度、信念和实践。我们于 2016 年 12 月至 2018 年 1 月通过邮寄、电子邮件和传真发送的调查，以及通过电话或亲自管理的方式，对 83 名符合条件的 PCP 进行了调查。该调查包括有关提供者与 LCS 和 USPSTF 指南相关的临床实践、知识、态度和信念的问题。还收集了有关患者人口统计学、PCP 培训背景和实践类型的信息。67%的受访者表示他们的实践中没有 LCS 的既定指南，52%的人表示“模糊”的筛查标准影响了他们的 LCS 转诊过程。LDCT 肺癌筛查的障碍包括担心 LDCT 不在保险范围内、患者对筛查结果的恐惧以及患者对辐射暴露的担忧。针对 PCP 和患者的有针对性的教育干预措施可能会增加推荐的 LCS 的可及性，特别是对于那些肺癌风险不成比例的人群。
