Factors Affecting Patient Adherence to Lung Cancer Screening
Factors Affecting Patient Adherence to Lung Cancer Screening
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DOI：
10.14423/smj.0000000000001167
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发表时间：
2020-11-01
影响因子：
1.1
通讯作者：
Kuperberg, Stephen
中科院分区：
文献类型：
--
作者：
Bellinger, Christina;Foley, Kristie;Kuperberg, Stephen
目标：国家肺部筛查试验 (NLST) 证明，低剂量计算机断层扫描 (CT) 进行肺癌筛查 (LCS) 可使死亡率降低 20%。 NLST 发现，对于在 3 年随访期内接受年度筛查的患者，LCS 的益处最大。 NLST 中连续成像的遵守率为 95%。 方法：我们对 268 名接受 LCS 且未参加研究的患者进行了一项前瞻性研究，以确定对单个中心推荐的后续成像和活检的遵守情况。我们评估了社会人口统计学特征、肺部影像和报告数据系统以及依从性之间的相关性。结果：只有 48% 的患者群体在参考 LCS 后接受了建议的随访（影像学或活检）。与筛查阴性的患者相比，LCS（肺成像和报告数据系统 3 或 4）异常的患者更有可能遵守推荐的随访（额外成像或活检）。性别、种族、吸烟状况和家庭收入与筛查和活检的依从性无关。结论：NLST 中观察到的 LCS 的益处可能会因后续筛查的依从性低而受到损害。需要针对 LCS 患者进行研究以提高随访的依从性。
Objectives: The National Lung Screening Trial (NLST) demonstrated a 20% reduction in mortality with low-dose computed tomography (CT) for lung cancer screening (LCS). The NLST found the greatest benefit to LCS for patients who underwent annual screening for a full 3-year follow-up period. The adherence to serial imaging in the NLST was 95%.Methods: We conducted a prospective study of 268 patients who presented for LCS and who were not enrolled in a research study to determine the adherence to recommended follow-up imaging and biopsy at a single center. We evaluated the correlations among sociodemographic characteristics, Lung Imaging and Reporting Data System, and adherence.Results: Only 48% of the patient population received recommended follow-up (either imaging or biopsy) after their referent LCS. Patients with abnormal LCS (Lung Imaging and Reporting Data System 3 or 4) were more likely to adhere to the recommended follow-up (additional imaging or biopsy) compared with those with negative screens. Sex, ethnicity, smoking status, and household income were not correlated with adherence to screening and biopsy.Conclusions: The benefits from LCS observed in the NLST may be undermined by low adherence to follow-up screening. Studies targeting LCS patients to bolster adherence to follow-up are needed.