Alali Akeel A
College of Medicine, Clinical Affairs, King Saud Bin Abdulaziz University for Health Sciences.
King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
J Thorac Imaging. 2024 Jan 1;39(1):W1-W4. doi: 10.1097/RTI.0000000000000741. Epub 2023 Sep 8.
The success of cancer screening depends on patient adherence to the screening program. The purpose of this study is to assess how the level of education might affect participants' compliance with screening in the National Lung Screening Trial (NLST).
Secondary data analyses of the participants in the NLST were performed. A total of 50,104 participants were included in this study. Participants who enrolled in the trial but refused the initial screening were compared with those who completed the screening. A multivariate logistic regression model was used to assess the association between participant noncompliance and education level.
A total of 3712 (7.41%) participants refused lung cancer screening in the NLST. Compared with the reference group, participants with an education level of eighth grade or less (odds ratio [OR]: 2.1, CI: 1.68-2.76), ninth-11th grade (OR: 1.9, CI: 1.7-2.34), high school graduates (OR: 1.3, CI: 1.22-1.54), after high school training (OR: 1.1, CI: 1-1.31), or an associate's degree (OR: 1.2, CI: 1.07-1.36) had significantly higher odds of refusing lung cancer screening. Participants with a bachelor's degree showed no significant association with compliance with screening (OR: 0.9, P = 0.86). Multivariate regression analysis also showed that younger, single, male participants with a longer duration of smoking history had significantly higher odds of refusing the screening.
A lower level of education was significantly associated with refusing lung cancer screening. A strategic targeted approach for this group might be necessary to promote their compliance rate.
癌症筛查的成功取决于患者对筛查项目的依从性。本研究旨在评估教育水平如何影响国家肺癌筛查试验（NLST）参与者对筛查的依从性。
对NLST的参与者进行二次数据分析。本研究共纳入50104名参与者。将参加试验但拒绝初次筛查的参与者与完成筛查的参与者进行比较。采用多因素逻辑回归模型评估参与者不依从与教育水平之间的关联。
NLST中共有3712名（7.41%）参与者拒绝肺癌筛查。与参照组相比，教育水平为八年级及以下（优势比[OR]：2.1，置信区间[CI]：1.68 - 2.76）、九年级至十一年级（OR：1.9，CI：1.7 - 2.34）、高中毕业生（OR：1.3，CI：1.22 - 1.54）、高中后培训（OR：1.1，CI：1 - 1.31）或副学士学位（OR：1.2，CI：1.07 - 1.36）的参与者拒绝肺癌筛查的几率显著更高。拥有学士学位的参与者与筛查依从性无显著关联（OR：0.9，P = 0.86）。多因素回归分析还显示，年龄较小、单身、吸烟史较长的男性参与者拒绝筛查的几率显著更高。
较低的教育水平与拒绝肺癌筛查显著相关。可能需要针对该群体采取有针对性的策略来提高他们的依从率。
