Leng Jennifer, Lui Florence, Chan Chloe, Chen Ruo Yan, Wu Minlun, Narang Bharat, Gany Francesca
Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
Public Health Pract (Oxf). 2025 May 9;9:100621. doi: 10.1016/j.puhip.2025.100621. eCollection 2025 Jun.
The U.S. Preventive Services Task Force (USPSTF) currently recommends annual lung cancer screening (LCS) with low-dose computed tomography (LDCT) for asymptomatic 50- to 80-year-old adults with a 20-pack year history who currently smoke or have quit smoking within the past 15 years. Foreign-born Chinese livery drivers are a group at disproportionately high risk for lung cancer due to high smoking prevalence and occupational exposure to airborne contaminants and carcinogens. This paper describes a pilot randomized controlled trial to educate and navigate high-risk, previously unscreened Chinese livery drivers to lung cancer screening, and describes barriers to recruitment and retention.
Pre-pilot and pilot randomized controlled trial.
The study was conducted in two phases, a pre-pilot and pilot randomized controlled trial between December 2019 and June 2023. In the pilot RCT, eligible participants were randomized to either (1) the CHW (Community Health Worker) intervention group or (2) a written materials only control group and participated for 6-12 months.
From December 2019 to June 2023, 25 subjects were enrolled: 12 in Phase 1 and 13 in Phase 2 (of 1018 approached). Recruitment barriers included the COVID-19 pandemic, institutional mistrust, smoking-related beliefs, and primary care provider-related barriers.
We identified specific socioenvironmental and cultural barriers to LCS uptake among Chinese immigrant men who smoke. Farther upstream cancer education interventions (e.g., provider and community-level education initiatives on LCS) conducted in partnership with community-based organizations should be considered to meet the needs of this population.
美国预防服务工作组（USPSTF）目前建议，对年龄在50至80岁、有20包年吸烟史、目前仍在吸烟或在过去15年内戒烟的无症状成年人，每年进行低剂量计算机断层扫描（LDCT）肺癌筛查。由于吸烟率高以及职业暴露于空气传播污染物和致癌物，出生在国外的华裔网约车司机是肺癌高危人群。本文描述了一项试点随机对照试验，旨在对高危且此前未接受过筛查的华裔网约车司机进行肺癌筛查教育并引导其进行筛查，并描述招募和留住参与者的障碍。
预试点和试点随机对照试验。
该研究分两个阶段进行，即2019年12月至2023年6月期间的预试点和试点随机对照试验。在试点随机对照试验中，符合条件的参与者被随机分为两组：（1）社区卫生工作者（CHW）干预组或（2）仅提供书面材料的对照组，并参与6至12个月。
2019年12月至2023年6月，共招募了25名受试者：第1阶段12名，第2阶段13名（共接触1018人）。招募障碍包括新冠疫情、机构不信任、与吸烟相关的观念以及与初级保健提供者相关障碍。
我们确定了吸烟的华裔移民男性在接受肺癌筛查方面存在的特定社会环境和文化障碍。应考虑与社区组织合作开展更上游的癌症教育干预措施（例如，针对肺癌筛查的提供者和社区层面教育举措），以满足该人群的需求。
