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精准医疗检测与非小细胞肺癌患者医疗保健中的差异:叙事性综述。

Precision Medicine Testing and Disparities in Health Care for Individuals With Non-Small Cell Lung Cancer: A Narrative Review.

机构信息

State University of New York.

University at Buffalo, New York.

出版信息

Oncol Nurs Forum. 2022 May 1;49(3):257-272. doi: 10.1188/22.ONF.257-272.

Abstract

PROBLEM IDENTIFICATION

Precision medicine initiatives provide opportunities for optimal targeted therapy in individuals with non-small cell lung cancer. However, there are barriers to these initiatives that reflect social determinants of health.

LITERATURE SEARCH

MEDLINE®, CINAHL®, PsycINFO®, Embase®, and Google ScholarTM databases were searched for articles published in English in the United States from 2016 to 2020.

DATA EVALUATION

Data that were collected included individual demographic information, specific diagnosis, status of targeted genomic testing, and receipt of targeted therapy. All studies were retrospective and involved database review of insurance claims or medical records.

SYNTHESIS

Individuals with non-small cell lung cancer received less genetic testing and targeted therapy if they were of a lower socioeconomic status, had public health insurance or no health insurance, were Black, or lived in rural communities.

IMPLICATIONS FOR NURSING

Social determinants of health affect health equity, including in precision medicine initiatives for individuals with lung cancer. Gaining an understanding of this impact is the first step in mitigating inequities.

摘要

问题识别

精准医疗计划为非小细胞肺癌患者提供了优化靶向治疗的机会。然而,这些计划存在反映健康社会决定因素的障碍。

文献检索

在美国,从 2016 年到 2020 年,在 MEDLINE®、CINAHL®、PsycINFO®、Embase®和 Google ScholarTM 数据库中搜索了以英文发表的文章。

数据评估

收集的数据包括个人人口统计学信息、具体诊断、靶向基因组检测状态和接受靶向治疗的情况。所有研究均为回顾性研究,涉及对保险索赔或病历的数据库审查。

综合分析

如果非小细胞肺癌患者社会经济地位较低、拥有公共医疗保险或没有医疗保险、是黑人或居住在农村社区,他们接受的基因检测和靶向治疗就会减少。

对护理的影响

健康的社会决定因素会影响健康公平,包括对肺癌患者的精准医疗计划。了解这种影响是减轻不公平现象的第一步。

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