Royal Brompton and Harefield NHS Foundation Trust, Department of Radiology, London, UK.
National Heart and Lung Institute, Imperial College, London, UK.
NPJ Prim Care Respir Med. 2021 Jun 7;31(1):36. doi: 10.1038/s41533-021-00246-8.
Regional lung cancer screening (LCS) is underway in England, involving a "lung health check" (LHC) and low-dose CT scan for those at high risk of cancer. Incidental findings from LHCs or CTs are usually referred to primary care. We describe the proportion of participants referred from the West London LCS pilot to primary care, the indications for referral, the number of general practitioner (GP) attendances and consequent changes to patient management, and provide an estimated cost-burden analysis for primary care. A small proportion (163/1542, 10.6%) of LHC attendees were referred to primary care, primarily for suspected undiagnosed chronic obstructive pulmonary disease (55/163, 33.7%) or for QRISK® (63/163, 38.7%) assessment. Ninety one of 159 (57.2%) participants consenting to follow-up attended GP appointments; costs incurred by primary care were estimated at £5.69/LHC participant. Patient management changes occurred in only 36/159 (22.6%) referred participants. LHCs result in a small increase to primary care workload provided a strict referral protocol is adhered to. Changes to patient management arising from incidental findings referrals are infrequent.
英国正在进行区域性肺癌筛查（LCS），包括对高危癌症人群进行“肺部健康检查”（LHC）和低剂量 CT 扫描。LHC 或 CT 的偶然发现通常会被转介至初级保健。我们描述了从伦敦西部 LCS 试点中被转介至初级保健的参与者的比例、转介的指征、全科医生（GP）就诊的次数以及随之而来的患者管理变化，并对初级保健的费用负担进行了估算。一小部分（163/1542，10.6%）的 LHC 参与者被转介至初级保健，主要是因为疑似未确诊的慢性阻塞性肺疾病（55/163，33.7%）或 QRISK®（63/163，38.7%）评估。在同意随访的 159 名参与者中有 91 名（57.2%）参加了 GP 预约；初级保健的费用估计为每个 LHC 参与者 5.69 英镑。仅在 36/159（22.6%）被转介的参与者中发生了患者管理变化。如果严格遵守转诊方案，LHC 会给初级保健工作带来一定的增加。偶然发现转介引起的患者管理变化很少见。
