Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil.
Department of Diagnostic and Interventional Radiology, 67766Barretos Cancer Hospital, Barretos, Brazil.
Cancer Control. 2022 Jan-Dec;29:10732748221121385. doi: 10.1177/10732748221121385.
Lung cancer is the deadliest cancer worldwide and in Brazil. Despite strong evidence, lung cancer screening by low-dose computed tomography (LDCT) in high-risk individuals is far from a reality in many countries, particularly in Brazil. Brazil has a universal public health system marked with important inequalities. One affordable strategy to increase the coverage of resources is to use mobile units.
To describe the implementation and results of an innovative lung cancer prevention program that integrates tobacco cessation and lung cancer screening using a mobile CT unit.
From May 2019 to Dec 2020, health professionals from 18 public primary health care units in Barretos, Brazil, were trained to offer smoking cessation counseling and treatment. Eligible high-risk participants of this program were also invited to perform lung cancer screening in a mobile LDCT unit that was specially conceived to be dispatched to the community. A detailed epidemiological questionnaire was administered to the LDCT participants.
Among the 233 screened participants, the majority were women (54.9%), and the average age was 62 years old. A total of 52.8% of participants showed high or very high nicotine dependence. After 1 year, 27.8% of participants who were involved in smoking cessation groups had quit smoking. The first LDCT round revealed that the majority of participants (83.7%) exhibited lung-Rads 1 or 2; 7.3% exhibited lung-Rads 3; 7.7% exhibited lung-Rads 4a; and 3% exhibited lung-Rads 4b or 4x. The three participants with lung-Rads 4b were further confirmed, and their surgery led to the diagnosis of early-stage cancer (1 case of adenocarcinoma and two cases of squamous cell carcinoma), leading to a cancer diagnosis rate of 12.8/1000.
Our results indicate promising outcomes for an onsite integrative program enrolling high-risk individuals in a middle-income country. Evidence barriers and challenges remain to be overcome.
肺癌是全球和巴西最致命的癌症。尽管有确凿的证据，但在许多国家，包括巴西，低剂量计算机断层扫描（LDCT）对高危人群进行肺癌筛查还远未成为现实。巴西拥有一个以显著不平等为特征的全民公共卫生系统。增加资源覆盖范围的一种负担得起的策略是使用移动单位。
描述一种创新的肺癌预防计划的实施和结果，该计划整合了使用移动 CT 单元进行戒烟和肺癌筛查。
从 2019 年 5 月到 2020 年 12 月，来自巴西巴雷托斯的 18 个公共初级保健单位的卫生专业人员接受了提供戒烟咨询和治疗的培训。该计划的合格高危参与者也被邀请在专门设计用于派往社区的移动 LDCT 单元中进行肺癌筛查。对 LDCT 参与者进行了详细的流行病学问卷调查。
在 233 名接受筛查的参与者中，大多数是女性（54.9%），平均年龄为 62 岁。共有 52.8%的参与者表现出高或非常高的尼古丁依赖。戒烟小组参与一年后，27.8%的参与者已经戒烟。第一轮 LDCT 显示，大多数参与者（83.7%）的肺部-Rads 为 1 或 2；7.3%的肺部-Rads 为 3；7.7%的肺部-Rads 为 4a；3%的肺部-Rads 为 4b 或 4x。有 3 名肺部-Rads 为 4b 的患者进一步得到证实，他们的手术导致早期癌症的诊断（1 例腺癌和 2 例鳞状细胞癌），癌症诊断率为 12.8/1000。
我们的结果表明，在中低收入国家，为高风险个体招募参加现场综合计划的结果很有希望。仍然存在证据障碍和挑战需要克服。
