Do Lung Cancer Eligibility Criteria Align with Risk among Blacks and Hispanics?
Do Lung Cancer Eligibility Criteria Align with Risk among Blacks and Hispanics?
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DOI：
10.1371/journal.pone.0143789
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发表时间：
2015-11-30
期刊：
影响因子：
3.7
通讯作者：
Mohile, Supriya G.
中科院分区：
文献类型：
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作者：
Fiscella, Kevin;Winters, Paul;Mohile, Supriya G.
背景黑人患者有较高的肺癌风险，尽管吸烟包年数较低。我们评估了肺癌的风险，种族和性别之间的一个全国性的代表性人口符合肺癌筛查的基础上Medicare criteria.MethodsWe使用的数据从国家健康和营养检查调查，2007-2012年评估肺癌的风险，性别，种族和种族之间的人满足医疗保险的年龄和包年吸烟肺癌筛查的资格标准。我们根据年龄（55-77岁）和包年（>= 30）评估了医疗保险资格。我们使用2012年修改的前列腺癌、肺癌、结直肠癌和卵巢癌筛查试验（PLCOm 2012）的风险预测模型评估了6年肺癌风险。我们比较了符合条件的人的比例按性别，种族和民族使用医疗保险标准的风险临界点，调整，以达到可比的总人数的人有资格进行screening.ResultsAmong 29.7万人年龄在55-77岁谁曾经吸烟，我们发现，730万（24.5%）有资格进行肺癌筛查医疗标准。在符合条件的人群中，黑人肺癌风险（4.4%）和西班牙裔肺癌风险（1.2%）在统计学上显著高于非西班牙裔白人（3.2%）。在2.12%的肺部筛查合格风险临界点，黑人和西班牙裔的百分比显示出统计学显著性变化。符合条件的黑人增加了48%，西班牙裔减少了63%。黑人男性和西班牙裔女性受影响最大。有一个小的变化，在资格Whites.ConclusionMedicare肺癌筛查的资格标准不符合黑人和西班牙裔之间的肺癌的估计风险。迫切需要数据来确定使用基于风险的资格筛查是否可以改善少数民族患者的肺癌预后。
BackgroundBlack patients have higher lung cancer risk despite lower pack years of smoking. We assessed lung cancer risk by race, ethnicity, and sex among a nationally representative population eligible for lung cancer screening based on Medicare criteria.MethodsWe used data from the National Health and Nutrition Examination Survey, 2007-2012 to assess lung cancer risk by sex, race and ethnicity among persons satisfying Medicare age and pack-year smoking eligibility criteria for lung cancer screening. We assessed Medicare eligibility based on age (55-77 years) and pack-years (>= 30). We assessed 6-year lung cancer risk using a risk prediction model from Prostate, Lung, Colorectal and Ovarian Cancer Screening trial that was modified in 2012 (PLCOm2012). We compared the proportions of eligible persons by sex, race and ethnicity using Medicare criteria with a risk cut-point that was adjusted to achieve comparable total number of persons eligible for screening.ResultsAmong the 29.7 million persons aged 55-77 years who ever smoked, we found that 7.3 million (24.5%) were eligible for lung cancer screening under Medicare criteria. Among those eligible, Blacks had statistically significant higher (4.4%) and Hispanics lower lung cancer risk (1.2%) than non-Hispanic Whites (3.2%). At a cut-point of 2.12% risk for lung screening eligibility, the percentage of Blacks and Hispanics showed statistically significant changes. Blacks eligible rose by 48% and Hispanics eligible declined by 63%. Black men and Hispanic women were affected the most. There was little change in eligibility among Whites.ConclusionMedicare eligibility criteria for lung cancer screening do not align with estimated risk for lung cancer among Blacks and Hispanics. Data are urgently needed to determine whether use of risk-based eligibility screening improves lung cancer outcomes among minority patients.