Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA.
Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA; Center for Integrative Oncology & Survivorship, Prisma Health, 900 W Faris Rd 1st Floor, Greenville, SC 29605, USA.
Cancer Epidemiol. 2023 Aug;85:102396. doi: 10.1016/j.canep.2023.102396. Epub 2023 Jun 7.
To examine 1) the rate of lung cancer screening (LCS) utilization in a large healthcare system in South Carolina; 2) associations of urbanicity and travel time with LCS utilization.
LCS-eligible patients from 2019 were identified. The outcome was LCS utilization. The exposures were zip-code level urbanicity and travel time from the centroid of zip-code area to the nearest screening site (<10,10-<20, ≥20 min). Covariates included age, sex, race, marital status, insurance, body mass index, chronic obstructive pulmonary disease, Charlson Comorbidity Index (0, 1, 2, ≥3), and zip-code level median income. Chi-square tests and logistic regressions were employed.
The analysis included 6930 patients, among whom 1432 (20.66%) received LCS. After adjusting for covariates, living in a non-metropolitan area (adjusted odds ratio: 0.32; 95% confidence interval: 0.26-0.40) and having longer travel time (0.80 [0.65-0.98] and 0.68 [0.54-0.86] for 10-<20 and ≥20 min travel time, respectively, compared to <10 min travel time) were significantly associated with lower odds of LCS utilization.
The LCS utilization rate of a healthcare system was about 20% in 2019. Living in non-metropolitan areas or having longer travel time to LCS site were associated with lower LCS utilization.
在南卡罗来纳州的一个大型医疗保健系统中，检查 1）肺癌筛查（LCS）的利用率；2）城市性和旅行时间与 LCS 利用的关联。
确定 2019 年符合 LCS 条件的患者。结局是 LCS 的利用情况。暴露因素为邮政编码水平的城市化程度和从邮政编码区域中心到最近筛查地点的旅行时间（<10、10-<20、≥20 分钟）。协变量包括年龄、性别、种族、婚姻状况、保险、体重指数、慢性阻塞性肺疾病、Charlson 合并症指数（0、1、2、≥3）和邮政编码水平的中位数收入。采用卡方检验和逻辑回归进行分析。
分析纳入了 6930 名患者，其中 1432 名（20.66%）接受了 LCS。在调整了协变量后，居住在非都市地区（调整后的优势比：0.32；95%置信区间：0.26-0.40）和旅行时间较长（10-<20 分钟和≥20 分钟旅行时间分别为 0.80[0.65-0.98]和 0.68[0.54-0.86]，与<10 分钟旅行时间相比）与 LCS 利用率降低显著相关。
2019 年，医疗保健系统的 LCS 利用率约为 20%。居住在非都市地区或前往 LCS 地点的旅行时间较长与较低的 LCS 利用率相关。
