Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Public Health Management Corporation, Philadelphia, Pennsylvania, USA.
Popul Health Manag. 2022 Apr;25(2):254-263. doi: 10.1089/pop.2021.0249.
The National Lung Screening Trial established the benefits of low-dose computed tomography for lung cancer screening (LCS) to identify lung cancer at earlier stages. In February 2021, the US Preventive Services Task Force (USPSTF) revised the eligibility recommendations to increase the number of high-risk individuals eligible for LCS and, in effect, expand screening eligibility for vulnerable populations. One strategy for facilitating LCS is to implement targeted screening in geographic areas with the greatest need. In Philadelphia, although neighborhood smoking rates have been defined, it is not known which neighborhoods have the greatest number of people eligible for LCS. In this study, the authors estimate eligibility for LCS within Philadelphia neighborhoods using both previous and current USPSTF guidelines. They used the Public Health Management Corporation's Household Health Survey from 2010, 2012, and 2015 to identify the number of people within ever-smoker groups (current every day, current occasional, and former smokers) by neighborhood in Philadelphia. Using the 2015 National Health Interview Survey (NHIS) Cancer Supplement, they identified the percentages within ever-smoker groups that were LCS eligible using the previous and current USPSTF guidelines. Finally, they applied the percentages eligible for the ever-smoker groups from the NHIS to the numbers in these groups within Philadelphia neighborhoods. They found that the number of Philadelphians eligible for LCS increased from 41,946 to 89,231 after the revised USPSTF guidelines. The current USPSTF guidelines increased eligibility for LCS within all Philadelphia neighborhoods, with the greatest increases in the River Wards planning district. Local providers should use these results to prioritize LCS services within neighborhoods with greatest eligibility.
国家肺癌筛查试验（National Lung Screening Trial）证实了低剂量计算机断层扫描（low-dose computed tomography，LDCT）在肺癌筛查（lung cancer screening，LCS）中的益处，可更早发现肺癌。2021 年 2 月，美国预防服务工作组（US Preventive Services Task Force，USPSTF）修订了资格推荐标准，增加了适合 LCS 的高危人群数量，从而实际上扩大了弱势群体的筛查资格。促进 LCS 的一种策略是在最需要的地理区域实施靶向筛查。在费城，虽然已经确定了社区吸烟率，但尚不清楚哪些社区有最多的人适合接受 LCS。在这项研究中，作者使用之前和当前的 USPSTF 指南来估计费城社区内的 LCS 资格。他们使用公共卫生管理公司（Public Health Management Corporation）的家庭健康调查（Household Health Survey），该调查于 2010 年、2012 年和 2015 年进行，以确定费城各个社区中曾经吸烟者（当前每天吸烟、偶尔吸烟和曾经吸烟）的人数。他们利用 2015 年全国健康访谈调查（National Health Interview Survey，NHIS）癌症补充调查，根据之前和当前的 USPSTF 指南，确定曾经吸烟者中适合 LCS 的比例。最后，他们将 NHIS 中适合曾经吸烟者的比例应用于费城各个社区中这些人群的数量。结果发现，修订后的 USPSTF 指南实施后，适合 LCS 的费城人数从 41946 人增加到 89231 人。当前的 USPSTF 指南增加了所有费城社区的 LCS 资格，河滨行政区（River Wards planning district）的增幅最大。当地的提供者应使用这些结果，优先考虑最适合进行 LCS 的社区的服务。
