Likelihood of Lung Cancer Screening by Poor Health Status and Race and Ethnicity in US Adults, 2017 to 2020.
Likelihood of Lung Cancer Screening by Poor Health Status and Race and Ethnicity in US Adults, 2017 to 2020.
复制标题
2017年至2020年，美国成年人的健康状况，种族和种族较差的肺癌筛查的可能性。
DOI：
10.1001/jamanetworkopen.2022.5318
复制
发表时间：
2022-03-01
影响因子：
13.8
通讯作者：
Keyhani S
中科院分区：
文献类型：
--
作者：
Rustagi AS;Byers AL;Keyhani S
This cross-sectional, population-based study examines rates of lung cancer screening to evaluate whether health status and racial and ethnic disparities are associated with rates of screening. Is lung cancer screening reaching individuals who can gain the most from it? In this cross-sectional study of 14 550 US individuals, patients with worse self-rated health or more medical conditions, which can limit the benefit of early detection of lung cancer, were more likely than individuals with better health status to report lung cancer screening. Adjusting for health status, non-Hispanic Black individuals were 53% less likely to report screening than non-Hispanic White individuals. These findings suggest that individuals in poor health are more likely than those with good health status to undergo lung cancer screening, which can lessen its potential mortality benefit, and non-Hispanic Black individuals are less likely to undergo lung cancer screening despite its likely greater benefit in this group. Lung cancer screening (LCS) via low-dose chest computed tomography can prevent mortality through surgical resection of early-stage cancers, but it is unknown whether poor health is associated with screening. Though LCS may be associated with better outcomes for non-Hispanic Black individuals, it is unknown whether racial or ethnic disparities exist in LCS use. To determine whether health status is associated with LCS and whether racial or ethnic disparities are associated with LCS independently of health status. This cross-sectional, population-based study of community-dwelling US adults used data from Behavioral Risk Factor Surveillance System annual surveys, 2017 to 2020. Participants were aged 55 to 79 years, with a less than 30 pack-year smoking history, and were current smokers or those who quit within 15 years. Data were analyzed from August to November 2021. Self-reported health status and race and ethnicity. Self-reported LCS in the last 12 months. Of 14 550 individuals (7802 men [55.5%]; 7527 [55.0%] aged 65-79 years [percentages are weighted]), representing 3.68 million US residents, 17.0% (95% CI, 15.1%-18.9%) reported undergoing LCS. The prevalence of LCS was lower among non-Hispanic Black than non-Hispanic White individuals but not to a significant degree (12.0% [95% CI, 4.3%-19.7%] vs 17.5% [95% CI, 15.6%-19.5%]; P = .57). Health status was associated with LCS: 468 individuals in poor health vs 96 individuals in excellent health reported LCS (25.2% [95% CI, 20.6%-29.9%] vs 7.6% [95% CI, 5.0%-10.3%]; P < .001), and those with difficulty climbing stairs were more likely to report LCS than those without this functional limitation. Adjusting for sociodemographic factors, functional status, and comorbidities, self-rated health status remained associated with LCS (adjusted odds ratio, 1.19 per each 1-step decline in health; 95% CI, 1.03-1.38), and non-Hispanic Black individuals were 53% less likely to report LCS than non-Hispanic White individuals (adjusted odds ratio, 0.47; 95% CI, 0.24-0.90). Results were robust in sensitivity analyses in which health was alternatively quantified as number of comorbidities. LCS in the US is more common among those who may be less likely to benefit from screening because of poor underlying health. Furthermore, racial or ethnic disparities were evident after accounting for health status, with non-Hispanic Black individuals nearly half as likely as non-Hispanic White individuals to report LCS despite the potential for greater benefit of screening this population.
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DOI：
10.1016/j.lanepe.2021.100179
发表时间：
2021-11
期刊：
The Lancet regional health. Europe
影响因子：
--
作者：
Field JK;Vulkan D;Davies MPA;Baldwin DR;Brain KE;Devaraj A;Eisen T;Gosney J;Green BA;Holemans JA;Kavanagh T;Kerr KM;Ledson M;Lifford KJ;McRonald FE;Nair A;Page RD;Parmar MKB;Rassl DM;Rintoul RC;Screaton NJ;Wald NJ;Weller D;Whynes DK;Williamson PR;Yadegarfar G;Gabe R;Duffy SW
通讯作者：
Duffy SW
影响因子：
51.1
作者：
Chang, Joe Y.;Senan, Suresh;Paul, Marinus A.;Mehran, Reza J.;Louie, Alexander V.;Balter, Peter;Groen, Harry J. M.;McRae, Stephen E.;Widder, Joachim;Feng, Lei;van den Borne, Ben E. E. M.;Munsell, Mark F.;Hurkmans, Coen;Berry, Donald A.;van Werkhoven, Erik;Kresl, John J.;Dingemans, Anne-Marie;Dawood, Omar;Haasbeek, Cornelis J. A.;Carpenter, Larry S.;De Jaeger, Katrien;Komaki, Ritsuko;Slotman, Ben J.;Smit, Egbert F.;Roth, Jack A.
通讯作者：
Roth, Jack A.
影响因子：
6.2
作者：
Howard DH;Richards TB;Bach PB;Kegler MC;Berg CJ
通讯作者：
Berg CJ
影响因子：
2.6
作者：
Hunt, Bijou;Balachandran, Banujan
通讯作者：
Balachandran, Banujan
影响因子：
2.9
作者：
Kim, Jong Hae
通讯作者：
Kim, Jong Hae