Poghosyan Hermine, Richman Ilana, Sarkar Sayantani, Presley Carolyn J
Yale School of Nursing, New Haven, Connecticut, USA.
Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, Connecticut, USA.
J Am Geriatr Soc. 2024 Apr;72(4):1155-1165. doi: 10.1111/jgs.18795. Epub 2024 Feb 15.
Lung cancer screening (LCS) use among adults with disabilities has not been well characterized. We estimated the prevalence of LCS use by disability types and counts and investigated the association between disability counts and LCS utilization among LCS-eligible adults.
We used cross-sectional data from the 2019 Behavioral Risk Factor Surveillance System, Lung Cancer Screening Module. Based on the 2013 US Preventive Services Task Force criteria for LCS, the sample included 4407 LCS-eligible adults, aged 55-79 years, with current or former (quit smoking in the past 15 years) tobacco use history of at least 30 pack-years. Disability types included limitations in hearing, vision, cognition, mobility, self-care, and independent living. We also categorized respondents by number of disabilities (no disability, 1 disability, 2 disabilities, 3+ disabilities). We utilized descriptive statistics and multivariable logistic regression analyses to determine the association between disability counts and the receipt of LCS (yes/no) in the past 12 months.
In 2019, 16.4% of LCS-eligible adults were screened for lung cancer. Overall, 49.6% of participants had no disability, and 14.5% had >3 disabilities. Mobility was the most prevalent disability type (35.4%), followed by cognitive impairment (18.2%) and hearing (16.6%). LCS was more prevalent in adults with disability in self-care versus no disability in self-care (24.0% vs. 15.5%, p = 0.01), disability in independent living versus no disability in independent living (22.2% vs. 15.4%, p = 0.02), and cognitive impairment disability versus no cognitive impairment (22.1% vs. 15.3%, p = 0.03). The prevalence rates of LCS among groups of LCS-eligible adults with different disability counts were not significant (p = 0.17).
Despite the lack of clinical guidelines on LCS among individuals with disabilities, some individuals with disabilities are being screened for lung cancer. Future research should address this knowledge gap to determine clinical benefit versus harm of LCS among those with disabilities.
残疾成年人中肺癌筛查（LCS）的使用情况尚未得到充分描述。我们估计了按残疾类型和数量划分的LCS使用患病率，并调查了符合LCS条件的成年人中残疾数量与LCS利用率之间的关联。
我们使用了来自2019年行为危险因素监测系统肺癌筛查模块的横断面数据。根据2013年美国预防服务工作组的LCS标准，样本包括4407名符合LCS条件的成年人，年龄在55 - 79岁之间，有目前或既往（过去15年内戒烟）至少30包年的吸烟史。残疾类型包括听力、视力、认知、行动能力、自我护理和独立生活方面的限制。我们还根据残疾数量（无残疾、1种残疾、2种残疾、3种及以上残疾）对受访者进行分类。我们利用描述性统计和多变量逻辑回归分析来确定残疾数量与过去12个月内接受LCS（是/否）之间的关联。
2019年，16.4%的符合LCS条件的成年人接受了肺癌筛查。总体而言，49.6%的参与者无残疾，14.5%的参与者有3种以上残疾。行动能力是最常见的残疾类型（35.4%），其次是认知障碍（18.2%）和听力（16.6%）。自我护理有残疾的成年人中LCS的患病率高于自我护理无残疾的成年人（24.0%对15.5%，p = 0.01），独立生活有残疾的成年人中LCS的患病率高于独立生活无残疾的成年人（22.2%对15.4%，p = 0.02），有认知障碍残疾的成年人中LCS的患病率高于无认知障碍的成年人（22.1%对15.3%，p = 0.03）。不同残疾数量的符合LCS条件的成年人群体中LCS的患病率无显著差异（p = 0.17）。
尽管缺乏针对残疾人LCS的临床指南，但一些残疾人正在接受肺癌筛查。未来的研究应填补这一知识空白，以确定LCS对残疾人的临床益处与危害。
