Doria-Rose V Paul, Silvestri Gerard A, Durham Danielle D, Connor Philip, Goldman Lenka, Enewold Lindsey, Farjah Farhood, Miller Eric A, Simanowith Michael, Smith Robert A, Henderson Louise M, Osarogiagbon Raymond U, Kazerooni Ella A, Ward Andrew, Pinsky Paul
Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.
Thoracic Oncology Research Group, Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina.
JTO Clin Res Rep. 2025 Mar 20;6(6):100825. doi: 10.1016/j.jtocrr.2025.100825. eCollection 2025 Jun.
Lung cancer screening has been recommended by the United States Preventive Services Taskforce since 2013. The Centers for Medicare and Medicaid Services coverage decision in early 2015 required data submission to a Centers for Medicare and Medicaid Services-approved registry for facilities to receive payment for screening. Only the American College of Radiology's Lung Cancer Screening Registry (LCSR) received approval for this purpose. Some LCSR elements, such as race, ethnicity, downstream diagnostic procedures, and cancer outcomes, were underreported.
To address underreporting, we linked data from the LCSR to Medicare and Surveillance, Epidemiology, and End Results cancer registry data from 2015 to 2021. We created two different cohorts of individuals aged 65 years and older: (1) those who were enrolled in Medicare fee-for-service plans with parts A and B coverage at the time of at least one LCSR-reported screen, and (2) Medicare beneficiaries (regardless of whether fee-for-service or managed care) living within a Surveillance, Epidemiology, and End Results catchment area at the time of at least one LCSR-reported screen. We compared the characteristics of individuals in the linked cohorts with those of all individuals in the LCSR aged 65 years and over.
Demographic, smoking history, and screening examination data elements in the linked data were generally similar to those in the overall LCSR.
On the basis of these results, the linked populations seem to be generally representative of older individuals in the LCSR. These unique data linkages provide an unprecedented opportunity to better understand the early implementation of lung cancer screening in the United States.
自2013年以来，美国预防服务工作组一直推荐进行肺癌筛查。2015年初，医疗保险和医疗补助服务中心的覆盖范围决定要求各机构将数据提交至医疗保险和医疗补助服务中心批准的登记处，以便获得筛查费用支付。只有美国放射学会的肺癌筛查登记处（LCSR）获此用途的批准。LCSR的一些数据元素，如种族、族裔、下游诊断程序和癌症结局，报告不足。
为解决报告不足的问题，我们将LCSR的数据与2015年至2021年医疗保险以及监测、流行病学和最终结果癌症登记处的数据相链接。我们创建了两个不同的65岁及以上人群队列：（1）在至少一次LCSR报告的筛查时参加了医疗保险按服务收费计划且涵盖A部分和B部分的人群，以及（2）在至少一次LCSR报告的筛查时居住在监测、流行病学和最终结果覆盖区域内的医疗保险受益人（无论是否为按服务收费或管理式医疗）。我们将链接队列中的个体特征与LCSR中所有65岁及以上个体的特征进行了比较。
链接数据中的人口统计学、吸烟史和筛查检查数据元素通常与整个LCSR中的数据元素相似。
基于这些结果，链接人群似乎总体上代表了LCSR中的老年个体。这些独特的数据链接为更好地了解美国肺癌筛查的早期实施提供了前所未有的机会。
