Longitudinal predictors of adherence to annual follow-up in a lung cancer screening programme
Longitudinal predictors of adherence to annual follow-up in a lung cancer screening programme
复制标题
DOI：
10.1258/jms.2011.010127
复制
发表时间：
2011-01-01
影响因子：
2.9
通讯作者：
Ostroff, Jamie S.
中科院分区：
文献类型：
--
作者：
AWildstein, Kimberly;Faustini, Yolanda;Ostroff, Jamie S.
目的探讨两组患者每年重复肺癌筛查的依从率和相关因素。参与者和方法自费队列（n = 2083）为40岁及以上、无癌症病史和吸烟史的个体。参与者必须从医生那里获得低剂量计算机断层扫描（CT）的处方，并负责支付300美元，因为这些CT扫描通常不在保险范围内。无报酬队列（n = 1304）是年龄在60岁及以上、有吸烟史且无癌症病史的个体。首次和一年的重复CT免费提供。每个队列的依从率通过人口学变量、吸烟史、肺癌家族史、吸烟状况（以前/现在）、患肺癌的感知风险和担忧以及基线筛查CT来分析。结果自费组的年度随访依从性低于无自费组（62%对88%）。在白人和拥有大学学位的人群中，自付组和不付组的依从率都更高。在自付队列中，患肺癌的风险越大，依从性就越高。在基线CT上发现的非钙化结节增加了自费组的依从性，但降低了自费组的依从性。结论这些发现应用于开发教育材料和有针对性的保留策略，以提高肺癌重复筛查的依从性。
Objective To examine rates and factors associated with adherence to annual repeat lung cancer screening in two cohorts.Participants and methods The self-pay cohort (n = 2083) was individuals aged 40 years and older with no prior cancer and a smoking history. Participants had to obtain a prescription from their doctor for the low dose, computerized tomography scan (CT), and were responsible for payment of $300 as these CT scans are not typically covered by insurance. The no-pay cohort (n = 1304) was individuals aged 60 and older with a smoking history, and no prior cancer. The initial and one year repeat CT were provided free of charge. Rates of adherence for each cohort were analyzed by demographic variables, smoking history, family history of lung cancer, smoking status (former/current), perceived risk and worry of getting lung cancer and baseline screening CT.Results Adherence to annual follow-up was lower for the self-pay than for the no-pay cohort (62% vs. 88%). Both the self-pay and no-pay cohorts had higher adherence rates among Caucasians and those who had a college degree. A greater perceived risk of getting lung cancer increased adherence among the self-pay cohort. Non-calcified nodules found on baseline CT increased the adherence for the self-pay cohort, but decreased the adherence for the no-pay cohort.Conclusions These findings should be used in developing educational materials and targeted retention strategies to increase adherence with repeat lung cancer screening.