Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL; UF Health Cancer Center, Gainesville, FL.
Department of Epidemiology, College of Public Health and Health Professions, University of Florida, Gainesville, FL.
Clin Lung Cancer. 2024 Jan;25(1):39-49. doi: 10.1016/j.cllc.2023.08.013. Epub 2023 Aug 18.
Physician-patient discussions regarding lung cancer screening (LCS) are uncommon and its racial and ethnic disparities are under-investigated. We examined the racial and ethnic disparities in the trends and frequency of LCS discussion among the LCS-eligible United States (US) population.
We analyzed data from the Health Information National Trends Survey from 2014 to 2020. LCS-eligible individuals were defined as adults aged 55 to 80 years old who have a current or former smoking history. We estimated the trends and frequency of LCS discussions and adjusted the probability of having an LCS discussion by racial and ethnic groups.
Among 2136 LCS-eligible participants (representing 22.7 million US adults), 12.9% (95% CI, 10.9%-15%) reported discussing LCS with their providers in the past year. The frequency of LCS discussion was lowest among non-Hispanic White participants (12.3%, 95% CI, 9.9%-14.7%) compared to other racial and ethnic groups (14.1% in Hispanic to 15.3% in non-Hispanic Black). A significant increase over time was only observed among non-Hispanic Black participants (10.1% in 2014 to 22.1% in 2020; P = .05) and non-Hispanic Whites (8.5% in 2014 to 14% in 2020; P = .02). In adjusted analyses, non-Hispanic Black participants (14.6%, 95% CI, 12.3%-16.7%) had a significantly higher probability of LCS discussion than non-Hispanic Whites (12.1%, 95% CI, 11.4%-12.7%).
Patient-provider LCS discussion was uncommon in the LCS-eligible US population. Non-Hispanic Black individuals were more likely to have LCS discussions than other racial and ethnic groups. There is a need for more research to clarify the discordance between LCS discussions and the actual screening uptake in this population.
在美国,医生与患者讨论肺癌筛查(LCS)的情况并不常见,且针对其存在的种族和民族差异的研究也较少。本研究旨在探讨美国肺癌筛查合格人群中,LCS 讨论的趋势和频率是否存在种族和民族差异。
我们分析了 2014 年至 2020 年期间健康信息国家趋势调查的数据。将年龄在 55 岁至 80 岁之间、有当前或既往吸烟史的成年人定义为 LCS 合格人群。我们估计了 LCS 讨论的趋势和频率,并按种族和民族群体调整了进行 LCS 讨论的概率。
在 2136 名 LCS 合格参与者(代表 2270 万美国成年人)中,12.9%(95%置信区间,10.9%-15%)报告在过去一年中与他们的医疗保健提供者讨论过 LCS。与其他种族和民族群体相比(西班牙裔为 14.1%,非西班牙裔黑人为 15.3%),非西班牙裔白人参与者(12.3%,95%置信区间,9.9%-14.7%)报告进行 LCS 讨论的频率最低。仅在非西班牙裔黑人群体中观察到随时间的显著增加(2014 年为 10.1%,2020 年为 22.1%;P=.05)和非西班牙裔白人群体(2014 年为 8.5%,2020 年为 14%;P=.02)。在调整后的分析中,非西班牙裔黑人群体(14.6%,95%置信区间,12.3%-16.7%)进行 LCS 讨论的可能性明显高于非西班牙裔白人群体(12.1%,95%置信区间,11.4%-12.7%)。
在美国的 LCS 合格人群中,医患之间很少讨论 LCS。非西班牙裔黑人比其他种族和民族群体更有可能进行 LCS 讨论。需要进一步研究来阐明该人群中 LCS 讨论与实际筛查参与之间的差异。