Black patients referred to a lung cancer screening program experience lower rates of screening and longer time to follow-up
Black patients referred to a lung cancer screening program experience lower rates of screening and longer time to follow-up
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DOI：
10.1186/s12885-020-06923-0
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发表时间：
2020-06-16
期刊：
影响因子：
3.8
通讯作者：
Barta, Julie A.
中科院分区：
文献类型：
--
作者：
Lake, Michael;Shusted, Christine S.;Barta, Julie A.
背景在癌症预防护理中，种族差异已被充分记录，但在肺癌筛查中尚未充分探讨。我们试图探索在我们的城市学术医疗中心的肺癌筛查项目（LCSP）中肺癌筛查结果的种族差异，包括基线低剂量计算机断层扫描（LDCT）结果的差异，随访时间，依从性，以及额外成像后恢复年度筛查，失访和基线扫描阳性患者的癌症诊断。方法对转诊至我们LCSP的患者进行历史队列研究，以提取人口统计学和临床特征、吸烟史和肺癌筛查结果。结果在转诊到LCSP后，黑人接受LDCT的几率显著低于白人，即使控制了个体肺癌风险因素和社区水平因素。黑人也表现出延迟随访、依从性降低和所有肺RADS类别的失访趋势。结论：总体而言，肺癌筛查的年依从率较低，无论种族如何，强调需要增加患者教育和外展。此外，我们发现的种族差异鼓励进一步研究，目的是创造文化能力和包容性的LCSP。
Background Racial disparities are well-documented in preventive cancer care, but they have not been fully explored in the context of lung cancer screening. We sought to explore racial differences in lung cancer screening outcomes within a lung cancer screening program (LCSP) at our urban academic medical center including differences in baseline low-dose computed tomography (LDCT) results, time to follow-up, adherence, as well as return to annual screening after additional imaging, loss to follow-up, and cancer diagnoses in patients with positive baseline scans. Methods A historical cohort study of patients referred to our LCSP was conducted to extract demographic and clinical characteristics, smoking history, and lung cancer screening outcomes. Results After referral to the LCSP, blacks had significantly lower odds of receiving LDCT compared to whites, even while controlling for individual lung cancer risk factors and neighborhood-level factors. Blacks also demonstrated a trend toward delayed follow-up, decreased adherence, and loss to follow-up across all Lung-RADS categories. Conclusions Overall, lung cancer screening annual adherence rates were low, regardless of race, highlighting the need for increased patient education and outreach. Furthermore, the disparities in race we identified encourage further research with the purpose of creating culturally competent and inclusive LCSPs.