Racial Disparities in Adherence to Annual Lung Cancer Screening and Recommended Follow-Up Care
Racial Disparities in Adherence to Annual Lung Cancer Screening and Recommended Follow-Up Care
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DOI：
10.1513/annalsats.202111-1253oc
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发表时间：
2022-09-01
影响因子：
8.3
通讯作者：
Vachani, Anil
中科院分区：
文献类型：
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作者：
Kim, Roger Y.;Rendle, Katharine A.;Vachani, Anil
理论基础：黑人患者接受推荐的肺癌筛查(LCS)后续治疗的频率低于白人患者，但尚不清楚这种种族差异是否在分散式和集中式肺癌筛查计划中持续存在。目的：确定在分散式或集中式肺癌筛查计划中接受肺癌筛查的个人对美国放射学会肺部成像报告和数据系统(LONG-RADS)建议的忠诚度，并评估种族与LCS依从性的关联。方法：我们对在美国五个不同的医疗系统接受肺癌筛查的患者进行了多中心回溯性队列研究。我们计算了基线筛查阴性(肺-RADS 1或2)的患者每年对LCS的依从性，并对基线筛查阳性(肺-RADS 3、4A、4B或4X)的患者按LCS方案类型分层，计算其对年度LCS的依从性，并使用多变量修正泊松回归评估种族与依从性之间的关联。结果：在接受LCS的6,134名患者中，5,142名(83.8%)基线筛查阴性，992名(16.2%)基线筛查阳性。遵守两年LCS(34.8%比76.1%；P
Rationale: Black patients receive recommended lung cancer screening (LCS) follow-up care less frequently than White patients, but it is unknown if this racial disparity persists across both decentralized and centralized LCS programs.Objectives: To determine adherence to American College of Radiology Lung Imaging Reporting and Data System (Lung-RADS) recommendations among individuals undergoing LCS at either decentralized or centralized programs and to evaluate the association of race with LCS adherence.Methods: We performed a multicenter retrospective cohort study of patients receiving LCS at five heterogeneous U.S. healthcare systems. We calculated adherence to annual LCS among patients with a negative baseline screen (Lung-RADS 1 or 2) and recommended follow-up care among those with a positive baseline screen (Lung-RADS 3, 4A, 4B, or 4X) stratified by type of LCS program and evaluated the association between race and adherence using multivariable modified Poisson regression.Results: Of the 6,134 total individuals receiving LCS, 5,142 (83.8%) had negative baseline screens, and 992 (16.2%) had positive baseline screens. Adherence to both annual LCS (34.8% vs. 76.1%; P