Parikh Malhar J, Chai Louis F, Russo Manuel Garcia, Tompkins Anastasiia K, Akinade Omowunmi, Erkmen Cherie P
Department of Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pa.
Department of Thoracic Medicine and Surgery, Center for Asian Health, Lewis Katz School of Medicine at Temple University, Philadelphia, Pa.
J Thorac Cardiovasc Surg. 2025 Jul;170(1):46-51.e1. doi: 10.1016/j.jtcvs.2024.12.007. Epub 2024 Dec 13.
High-risk populations for lung cancer, including Black men and those with lower socioeconomic status, experience worse outcomes when treated. The mortality benefit of lung cancer screening cannot be realized without adherence to annual screening. Our study aims to understand annual adherence to lung cancer screening in a population traditionally experiencing health disparities, thus identifying lung cancer screening's impact on lung cancer disparities.
A 10-year retrospective review of patients obtaining initial lung cancer screening (T) at a safety-net institution was performed. Adherence was defined as lung cancer screening completed 12 to 15 months from prior screening (1 annual = T, 2 annual = T, 3 annual = T). Extended adherence was defined as lung cancer screening completed 12 to 18 months from prior screening. Data were stratified demographically for comparative analysis.
A total of 6983 patients received lung cancer screening over 10 years. Only 8.13% adhered to T, 3.68% adhered to T, and 1.35% adhered to T. Extending the adherence criteria showed minimal improvement: T 10.54%, T 4.64%, and T 3.47%. At all intervals, male patients (vs female patients; T: 7.37% vs 9.04%, T: 3.39% vs 4.11%, T: 2.06% vs 2.33%) and Hispanics (vs Black and White; T 7.82% vs 8.53% vs 9.47%, T: 2.12% vs 3.42% vs 5.12%, T: 1.02% vs 1.69% vs 3.30%) had worse adherence. A small cohort presented early (1-11 months), a form of adherence not previously reported.
In a safety-net institution with a diverse population traditionally experiencing disparities, adherence to annual lung cancer screening was low (8.13%) and declining each subsequent year, especially among male and Hispanic patients. Targeted education regarding importance of annual lung cancer screening is needed to realize the lifesaving potential of lung cancer screening.
肺癌高危人群，包括黑人男性和社会经济地位较低者，在接受治疗时预后较差。若不坚持年度筛查，就无法实现肺癌筛查的死亡率获益。我们的研究旨在了解在一个传统上存在健康差异的人群中对肺癌筛查的年度依从情况，从而确定肺癌筛查对肺癌差异的影响。
对在一家安全网机构进行初次肺癌筛查（T）的患者进行了为期10年的回顾性研究。依从性定义为从上次筛查起12至15个月内完成肺癌筛查（1年一次=T，2年一次=T，3年一次=T）。延长依从性定义为从上次筛查起12至18个月内完成肺癌筛查。数据按人口统计学分层进行比较分析。
10年间共有6983例患者接受了肺癌筛查。只有8.13%的患者坚持T，3.68%的患者坚持T，1.35%的患者坚持T。放宽依从性标准后改善甚微：T为10.54%，T为4.64%，T为3.47%。在所有时间间隔内，男性患者（与女性患者相比；T：7.37%对9.04%，T：3.39%对4.11%，T：2.06%对2.33%）和西班牙裔患者（与黑人和白人相比；T 7.82%对8.53%对9.47%，T：2.12%对3.42%对5.12%，T：1.02%对1.69%对3.30%）的依从性较差。一小部分人群筛查较早（1至11个月），这是一种此前未报道过的依从形式。
在一个传统上存在差异的多样化人群的安全网机构中，对年度肺癌筛查的依从性较低（8.13%），且随后每年都在下降，尤其是在男性和西班牙裔患者中。需要针对年度肺癌筛查的重要性进行有针对性的教育，以实现肺癌筛查挽救生命的潜力。
