未来肺癌筛查计划在霍奇金淋巴瘤幸存者中的可能接受度：一项问卷调查研究。

Likely uptake of a future a lung cancer screening programme in Hodgkin lymphoma survivors: a questionnaire study.

机构信息

Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.

NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK.

出版信息

BMC Pulm Med. 2022 Apr 28;22(1):165. doi: 10.1186/s12890-022-01959-3.

DOI:10.1186/s12890-022-01959-3

PMID:35484621

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9052526/

Abstract

BACKGROUND

Many Hodgkin lymphoma (HL) survivors are at increased risk of subsequent malignant neoplasms (SMN), including lung cancer, due to previous treatment for HL. Lung cancer screening (LCS) detects early-stage lung cancers in ever smokers but HL survivors without a heavy smoking history are ineligible for screening. There is a rationale to develop a targeted LCS. The aim of this study was to investigate levels of willingness to undergo LCS in HL survivors, and to identify the psycho-social factors associated with screening hesitancy.

METHODS

A postal questionnaire was sent to 281 HL survivors registered in a long-term follow-up database and at increased risk of SMNs. Demographic, lung cancer risk factors, psycho-social and LCS belief variables were measured. Multivariable logistic regression analysis was performed to determine the factors associated with lung cancer screening hesitancy, defined as those who would 'probably' or 'probably not' participate.

RESULTS

The response rate to the questionnaire was 58% (n = 165). Participants were more likely to be female, older and living in a less deprived area than non-participants. Uptake (at any time) of breast and bowel cancer screening among those previously invited was 99% and 77% respectively. 159 participants were at excess risk of lung cancer. The following results refer to these 159. Around half perceived themselves to be at greater risk of lung cancer than their peers. Only 6% were eligible for lung cancer screening pilots aimed at ever smokers in the UK. 98% indicated they would probably or definitely participate in LCS were it available. Psycho-social variables associated with LCS hesitancy on multivariable analysis were male gender (OR 5.94 CI 1.64-21.44, p < 0.01), living in an area with a high index of multiple deprivation decile (deciles 6-10) (OR 8.22 CI 1.59-42.58, p < 0.05) and lower levels of self-efficacy (OR 1.64 CI 1.30-2.08 p < 0.01).

CONCLUSION

HL survivors responding to this survey were willing to participate in a future LCS programme but there was some hesitancy. A future LCS trial for HL survivors should consider the factors associated with screening hesitancy in order to minimise barriers to participation.

摘要

背景

许多霍奇金淋巴瘤（HL）幸存者由于之前治疗 HL 而面临更高的后续恶性肿瘤（SMN）风险，包括肺癌。肺癌筛查（LCS）可在吸烟者中早期发现肺癌，但没有大量吸烟史的 HL 幸存者不符合筛查条件。因此有理由开发一种靶向 LCS。本研究旨在调查 HL 幸存者接受 LCS 的意愿水平，并确定与筛查犹豫相关的心理社会因素。

方法

我们向长期随访数据库中登记且有发生 SMN 风险的 281 名 HL 幸存者邮寄了一份问卷调查表。测量了人口统计学、肺癌危险因素、心理社会和 LCS 信念变量。多变量逻辑回归分析用于确定与肺癌筛查犹豫相关的因素，将那些“可能”或“可能不”参与的患者定义为筛查犹豫者。

结果

问卷的回复率为 58%（n=165）。与未参与者相比，参与者更可能为女性、年龄较大且居住在贫困程度较低的地区。在之前受邀的参与者中，乳腺癌和肠癌筛查的参与率（任何时候）分别为 99%和 77%。159 名参与者有发生肺癌的超额风险。以下结果仅针对这 159 名参与者。大约一半的人认为自己患肺癌的风险高于同龄人。只有 6%的人有资格参加英国针对曾吸烟者的肺癌筛查试验。如果有机会，98%的人表示他们可能或肯定会参加 LCS。多变量分析显示，男性（比值比 5.94，95%置信区间 1.64-21.44，p<0.01）、居住在高多因素剥夺指数十分位数（十分位数 6-10）（比值比 8.22，95%置信区间 1.59-42.58，p<0.05）和自我效能感较低（比值比 1.64，95%置信区间 1.30-2.08，p<0.01）与 LCS 犹豫相关。