Comorbidity Profiles and Lung Cancer Screening among Older Adults US Behavioral Risk Factor Surveillance System 2017-2019
Comorbidity Profiles and Lung Cancer Screening among Older Adults US Behavioral Risk Factor Surveillance System 2017-2019
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DOI：
10.1513/annalsats.202010-1276oc
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发表时间：
2021-11-01
影响因子：
8.3
通讯作者：
Braithwaite, Dejana
中科院分区：
文献类型：
--
作者：
Advani, Shailesh;Zhang, Dongyu;Braithwaite, Dejana
理论基础：虽然现在建议那些符合标准的基于风险因素的资格标准的人使用低剂量计算机断层扫描(LDCT)进行肺癌筛查，但在美国老年人群中，低剂量计算机断层扫描(LDCT)在LCS摄取和LDCT摄取方面的共病作用尚未得到很好的确立。目的：检查美国共病、功能状态和LCS使用之间的关系。方法：使用2017-2019年行为风险因素监测系统的基于人群的数据，我们在符合美国预防服务工作组指南的LCS标准的参与者中检查了日常生活活动与LCS使用的共病条件和功能限制的关联。我们使用多变量加权Logistic回归模型来评估这些相关性，包括总体和按年龄(=65岁)、性别和吸烟史定义的子组。结果：在符合LCS资格标准的11,214名参与者中，1,731人(16%)接受了LCS合并LDCT。大多数是白人(90%)，男性(55%)，曾经吸烟者(52%)，至少患有一种慢性合并症(77%)。超过28%的人有三种或三种以上的共病情况，大约40%的参与者报告有某种形式的功能限制。在多变量模型中，过去一年内接受LCS合并LDCT的可能性与较高的共病数量呈正相关(>；=5比0：调整后优势比2.34；95%可信区间[CI]，1.22-4.48)，但与功能限制无关(>；=3比0：调整后优势比1.00；95%CI，0.66-1.50)。结论：合并疾病的存在与接受LCS合并LDCT的可能性更高。由于糟糕的健康状况可能会削弱筛查的好处，因此需要未来的研究来准确地描述符合LCS资格的个人的健康状况。
Rationale: Although lung cancer screening (LCS) with low-dose computed tomography (LDCT) is now recommended for those meeting standard risk factor-based eligibility criteria, the role of comorbidity in the uptake of LCS with LDCT in an older real-world U.S. population is not well established.Objectives: To examine the relationships between comorbidity, functional status, and LCS utilization in the United States.Methods: Using population-based data from the 2017-2019 Behavioral Risk Factor Surveillance System, we examined the association of comorbid conditions and functional limitations regarding activities of daily living with LCS utilization among participants that met the LCS criteria based on the U.S. Preventive Service Taskforce guidelines. We employed multivariable weighted logistic regression models to evaluate these associations, both overall and within subgroups defined by age (= 65 yr), sex, and smoking history.Results: Of 11,214 participants who met the eligibility criteria for LCS, 1,731 (16%) underwent LCS with LDCT. The majority were White (90%), male (55%), former smokers (52%), and living with at least one chronic comorbid condition (77%). More than 28% had three or more comorbid conditions, and approximately 40% of participants reported having some form of functional limitations. In the multivariable models, the likelihood of undergoing LCS with LDCT within the past year was positively associated with higher amount of comorbidity (>= 5 vs. 0: adjusted odds ratio, 2.34; 95% confidence interval [CI], 1.22-4.48) but not with functional limitations (>= 3 vs. 0: adjusted odds ratio, 1.00; 95% CI, 0.66-1.50).Conclusions: The presence of comorbid conditions is associated with a higher likelihood of undergoing LCS with LDCT. Because poor health status may diminish the benefits of screening, future research is needed to precisely characterize the health status of LCS-eligible individuals.