Rogova Anastasia, Lowenstein Lisa M, Reitzel Lorraine R, Casey Kathleen, Volk Robert J
Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX.
Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX.
Chest. 2025 Jul;168(1):269-275. doi: 10.1016/j.chest.2024.11.039. Epub 2024 Dec 12.
Annual lung cancer screening using low-dose CT (LDCT) imaging effectively reduces mortality from lung cancer and is recommended for people who are at high risk of developing the disease. The utilization of lung cancer screening, however, has remained low. Due to significantly higher cigarette smoking rates, patients with behavioral health disorders (those living with mental illness and/or substance use disorders) are more likely to be diagnosed with and die of lung cancer; at the same time, they are less likely to undergo cancer screenings. There is an urgent need for targeted efforts to improve access to lung cancer screening among this population disproportionately affected by the disease. In this commentary, we propose integrating lung cancer screening facilitation into services provided by behavioral health professionals who are uniquely positioned to reach these patients and deliver interventions to increase uptake of cancer screenings. We suggest several measures that could improve lung health outcomes of patients with behavioral health disorders: (1) training behavioral health professionals in lung cancer screening eligibility assessment; (2) providing patients with educational materials; (3) integrating shared decision-making counseling for lung cancer screening into behavioral health care settings; (4) providing the practical support needed to access screening; and (5) establishing effective partnerships with community organizations. Regardless of the level of engagement, possibly ranging from brief training to the implementation of comprehensive programs, any involvement will benefit patients. This integrated approach will contribute to reducing lung cancer mortality among patients with behavioral health disorders who have long experienced systemic health inequities.
使用低剂量CT（LDCT）成像进行年度肺癌筛查可有效降低肺癌死亡率，推荐用于罹患该疾病风险较高的人群。然而，肺癌筛查的利用率一直较低。由于吸烟率显著更高，患有行为健康障碍的患者（患有精神疾病和/或物质使用障碍的人）更有可能被诊断出患有肺癌并死于肺癌；与此同时，他们接受癌症筛查的可能性较小。迫切需要做出有针对性的努力，以改善这一受该疾病影响尤为严重的人群获得肺癌筛查的机会。在这篇评论文章中，我们建议将肺癌筛查促进工作纳入行为健康专业人员提供的服务中，这些专业人员处于独特的位置，能够接触到这些患者并提供干预措施，以提高癌症筛查的接受率。我们提出了几项可以改善患有行为健康障碍患者肺部健康结果的措施：（1）对行为健康专业人员进行肺癌筛查资格评估培训；（2）为患者提供教育材料；（3）将肺癌筛查的共同决策咨询纳入行为健康护理环境；（4）提供进行筛查所需的实际支持；（5）与社区组织建立有效的伙伴关系。无论参与程度如何，可能从简短培训到全面项目的实施，任何参与都将使患者受益。这种综合方法将有助于降低长期经历系统性健康不平等的患有行为健康障碍患者的肺癌死亡率。
