Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.
Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.
J Cancer Policy. 2021 Jun;28:100284. doi: 10.1016/j.jcpo.2021.100284. Epub 2021 Apr 5.
The purpose of this study was to examine low-dose computed tomography (LDCT) for lung cancer screening (LCS) eligibility, utilization, and factors associated with self-reported participation among eligible individuals.
Data from the 2017 and 2018 Oklahoma Behavioral Risk Factor Surveillance System (BRFSS) were used and analysis was restricted to data from individuals eligible for screening based on the US Preventive Services Task Force (USPSTF) guidelines. Analyses using recursive partitioning and weighted logistic regression were conducted from November 2019 to March 2020. The final study sample consisted of 596 respondents.
Only 10.84 % of participants reported LCS participation. Differences in participation by sex were observed. Among males, those with COPD were more likely to report participating in screening. Among females, those who self-reported their health status as "fair or worse" were more likely to participate in LCS.
Rates of utilization were higher in this study than in earlier estimates; however, utilization of LCS remains suboptimal. Although LCS participation rates were similar for males and females, differences were observed by sex. Opportunities exist to increase screening participation among eligible individuals, and findings from this study can be used for program planning such as patient engagement resources and effective clinical decision support.
This study further demonstrates the complex nature of cancer screening participation, specifically LDCT LCS. Under the current USPSTF guidelines only a small proportion of the population is considered eligible thus to prevent lung cancer mortality, the eligibility criteria regarding smoking history and screening age may need to be reevaluated. Furthermore, this study adds to the evidence that strategies to increase screening participation among eligible individuals may need to differ by sex.
本研究旨在检查低剂量计算机断层扫描（LDCT）在肺癌筛查（LCS）中的资格、利用情况以及与符合条件的个体自我报告参与相关的因素。
使用了 2017 年和 2018 年俄克拉荷马州行为风险因素监测系统（BRFSS）的数据，并且仅对基于美国预防服务工作组（USPSTF）指南有资格进行筛查的个体的数据进行了分析。从 2019 年 11 月至 2020 年 3 月进行了递归分区和加权逻辑回归分析。最终研究样本包括 596 名受访者。
只有 10.84%的参与者报告了 LCS 参与情况。观察到不同性别之间的参与差异。在男性中，患有 COPD 的人更有可能报告参与筛查。在女性中，自我报告健康状况为“一般或更差”的人更有可能参加 LCS。
与早期估计相比，本研究中的利用率较高，但 LCS 的利用率仍然不理想。尽管男性和女性的 LCS 参与率相似，但性别之间存在差异。有机会增加符合条件的个体的筛查参与率，本研究的结果可用于规划计划，如患者参与资源和有效的临床决策支持。
本研究进一步证明了癌症筛查参与的复杂性，特别是 LDCT LCS。根据当前的 USPSTF 指南，只有一小部分人口被认为有资格，因此，为了预防肺癌死亡率，关于吸烟史和筛查年龄的资格标准可能需要重新评估。此外，本研究增加了证据，表明增加符合条件的个体筛查参与率的策略可能因性别而异。
