Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts.
Department of Radiology, Mount Auburn Hospital, Cambridge, Massachusetts.
Cancer. 2021 Mar 1;127(5):748-756. doi: 10.1002/cncr.33322. Epub 2020 Nov 18.
In randomized controlled trials, lung cancer screening with low-dose chest computed tomography (LCS) has been reported to reduce lung cancer mortality. Although initial studies suggested that only approximately 5% of eligible patients have undergone LCS, recent studies have indicated that use of LCS may be increasing nationwide. The objective of the current study was to estimate recent LCS use using cross-sectional survey data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) survey.
The BRFSS is a nationally representative, cross-sectional telephone survey of adults in the United States (response rate of approximately 50%). The 2018 BRFSS survey included questions regarding LCS eligibility and use in 8 states. The primary outcome was the percentage of participants (aged 55-79 years with a smoking history of >30 pack-years) who reported undergoing LCS. Logistic regression analyses evaluated the association between LCS use and sociodemographic characteristics, adjusted for potential confounders and accounting for complex survey design elements.
A total of 26,910 participants were included, 9.9% of whom were eligible for LCS (95% CI, 8.8%-10.6%). Of the eligible patients, 19.2% reported undergoing LCS (95% CI, 14.0%-24.4%). Approximately 16.4% of current smokers were eligible for LCS (95% CI, 14.2%-18.6%). In our multiple variable analyses of eligible patients, age, sex, marital status, current smoking status, and race were not found to be associated with statistically significant differences in reported LCS (P > .05). Retired patients, patients with personal physicians, and patients who did not complete a high school education were more likely to report receiving LCS (P < .05).
Compared with previously published studies, the results of the current study suggested that LCS use is increasing. However, LCS use remains low (19%) among eligible participants.
在随机对照试验中，低剂量胸部计算机断层扫描（LCS）肺癌筛查已被报道可降低肺癌死亡率。尽管最初的研究表明，只有大约 5%的合格患者接受了 LCS，但最近的研究表明，全国范围内 LCS 的使用可能正在增加。本研究的目的是使用 2018 年行为风险因素监测系统（BRFSS）调查的横断面调查数据来估计最近的 LCS 使用情况。
BRFSS 是一项针对美国成年人（应答率约为 50%）的全国代表性、横断面电话调查。2018 年 BRFSS 调查包括 8 个州关于 LCS 资格和使用的问题。主要结局是报告接受 LCS 的参与者（年龄在 55-79 岁，吸烟史>30 包年）的百分比。逻辑回归分析评估了 LCS 使用与社会人口统计学特征之间的关联，调整了潜在混杂因素，并考虑了复杂的调查设计因素。
共纳入 26910 名参与者，其中 9.9%（95%CI，8.8%-10.6%）有资格接受 LCS。在合格患者中，19.2%（95%CI，14.0%-24.4%）报告接受了 LCS。大约 16.4%的当前吸烟者有资格接受 LCS（95%CI，14.2%-18.6%）。在我们对合格患者的多变量分析中，年龄、性别、婚姻状况、当前吸烟状况和种族与报告的 LCS 之间没有发现统计学上显著的差异（P>.05）。退休患者、有私人医生的患者和未完成高中学业的患者更有可能报告接受了 LCS（P<.05）。
与之前发表的研究相比，本研究结果表明 LCS 的使用正在增加。然而，在合格的参与者中，LCS 的使用仍然很低（19%）。
