Racial and socioeconomic disparities in lung cancer screening in the United States: A systematic review.
Racial and socioeconomic disparities in lung cancer screening in the United States: A systematic review.
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DOI：
10.3322/caac.21671
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Erhunmwunsee L
中科院分区：
文献类型：
--
作者：
Sosa E;D'Souza G;Akhtar A;Sur M;Love K;Duffels J;Raz DJ;Kim JY;Sun V;Erhunmwunsee L
非小细胞肺癌（NSCLC）是癌症死亡的主要原因。肺癌筛查（LCS）降低了NSCLC死亡率;然而，LCS研究缺乏多样性可能会限制其结果对面临NSCLC风险较高和预后较差的边缘化人群的普遍性。确定LCS管道中的不平等来源对于减少NSCLC结局的差异至关重要。我们检索了2010年1月1日至2020年2月27日期间发表的三个主要数据库中的研究，这些研究符合以下标准：1）包括年龄在45岁至80岁之间的人类受试者，他们是当前或既往吸烟者，2）以英语撰写，3）在美国进行，4）讨论了基于社会经济和种族的LCS结局。评估合格研究的偏倚风险。在筛选的3，721项研究中，有21项合格。符合条件的研究进行了评估，他们的研究结果被归类为三个主题相关的LCS差距所面临的黑人和社会经济上处于不利地位的个人：（1）资格;（2）利用，感知和效用;和（3）筛选后的行为和护理。LCS的差异存在沿着种族和社会经济线。有几个步骤沿着LCS管道，其中黑人和社会经济上处于不利地位的个人错过了LCS的潜在好处，导致死亡率增加。我们确定了需要进一步调查的潜在不平等来源。我们建议实施前瞻性试验，评估服务不足群体的资格标准，并制定干预措施，重点是提高利用率和后续护理，以减少LCS差异。
Non-small cell lung cancer (NSCLC) is the leading cause of cancer deaths. Lung cancer screening (LCS) reduces NSCLC mortality; however, a lack of diversity in LCS studies may limit the generalizability of their results to marginalized groups who face higher risk for and worse outcomes from NSCLC. Identifying sources of inequity in the LCS pipeline is essential to reduce disparities in NSCLC outcomes. We searched three major databases for studies published from January 1, 2010, to February 27, 2020, that met the following criteria: 1) included humans subjects between the ages of 45 and 80 years who were current or former smokers, 2) written in English, 3) conducted in the US, and 4) discussed socioeconomic and race-based LCS outcomes. Eligible studies were assessed for risk of bias. Of 3,721 studies screened, 21 were eligible. Eligible studies were evaluated, and their findings were categorized into three themes related to LCS disparities faced by Black and socioeconomically disadvantaged individuals: (1) eligibility; (2) utilization, perception, and utility; and (3) post-screening behavior and care. Disparities in LCS exist along racial and socioeconomic lines. There are several steps along the LCS pipeline in which Black and socioeconomically disadvantaged individuals miss the potential benefits of LCS, resulting in increased mortality. We identified potential sources of inequity that require further investigation. We recommend the implementation of prospective trials that evaluate eligibility criteria for underserved groups and the creation of interventions focused on improving utilization and follow-up care in order to decrease LCS disparities.
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影响因子：
4
作者：
Egleston BL;Meireles SI;Flieder DB;Clapper ML
通讯作者：
Clapper ML
影响因子：
10.3
作者：
Aberle, Denise R.;Adams, Amanda M.;Pinsky, Paul F.
通讯作者：
Pinsky, Paul F.
影响因子：
9.6
作者：
Cerfolio, Robert James;Bryant, Ayesha S.;Garver, Robert I.
通讯作者：
Garver, Robert I.
影响因子：
158.5
作者：
Bach, PB;Cramer, LD;Begg, CB
通讯作者：
Begg, CB
影响因子：
4.6
作者：
Ebner, Peggy J.;Ding, Li;David, Elizabeth A.
通讯作者：
David, Elizabeth A.