National Survey of Lung Cancer Screening Practices in Veterans Health Administration Facilities.
National Survey of Lung Cancer Screening Practices in Veterans Health Administration Facilities.
复制标题
退伍军人健康管理机构肺癌筛查实践全国调查。
DOI：
10.1016/j.amepre.2023.05.005
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发表时间：
2023
影响因子：
5.5
通讯作者：
Wiener,RendaS
中科院分区：
文献类型：
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作者：
Núñez,EduardoR;Slatore,ChristopherG;Tanner,NicholeT;Melzer,AnneC;Crothers,KristinaA;Lewis,JenniferA;Fabbrini,AngelaE;Brown,JamesK;Wiener,RendaS
肺癌筛查可以通过肺癌的早期发现挽救生命，专业学会推荐关键的肺癌筛查程序组件以确保高质量的筛查。然而，对于在常规临床环境中组成各种筛查程序模型的关键组成部分，人们知之甚少。目的是比较集中式、混合式和分散式肺癌筛查计划中这些关键成分的利用情况。2021年8月至12月期间，以电子方式向全国退伍军人健康管理局机构(N=122)进行了管理。对2022年3月至8月期间的结果进行分析，并按自我确定的肺癌筛查计划类型进行分层，我们检验了这样一种假设，即集中式筛查计划更有可能实施支持肺癌筛查的做法，其次是混合式和分散式计划，使用Cochran−Armitage趋势测试。结果总体而言，69家机构(56.6%)完成了调查，受访者是肺癌筛查协调员(39.1%)、肺科医生(33.3%)和肿瘤学家(10.1%)。机构最常自认为具有集中式(37.7%)计划模式，其次是混合式(30.4%)和分散式(20.3%)计划。支持肺癌筛查的实践有不同的实施方式，混合式和分散式项目不太可能有肺癌筛查登记处、肺癌筛查指导委员会或专门的肺癌筛查协调员。结论尽管各种肺癌筛查项目的组成部分之间存在重叠，但集中式项目更频繁地在初始筛查之前实施实践，以支持肺癌筛查。这项工作为未来的研究提供了一条途径，以确定哪些肺癌筛查做法有效地改善了肺癌筛查结果，这可能有助于在资源有限的情况下实施。
IntroductionLung cancer screening can save lives through the early detection of lung cancer, and professional societies recommend key lung cancer screening program components to ensure high-quality screening. Yet, little is known about the key components that comprise the various screening program models in routine clinical settings. The objective was to compare the utilization of these key components across centralized, hybrid, and decentralized lung cancer screening programs.MethodsThe survey was designed to identify current structures and processes of lung cancer screening programs. It was administered electronically to Veterans Health Administration facilities nationally (N=122) between August and December 2021. Results were analyzed between March and August 2022 and stratified by self-identified lung cancer screening program type, and we tested the hypothesis that centralized screening programs would be more likely to have implemented practices that support lung cancer screening, followed by hybrid and decentralized programs, using the Cochran−Armitage trend test.ResultsOverall, 69 (56.6%) facilities completed the survey, and respondents were lung cancer screening coordinators (39.1%), pulmonologists (33.3%), and oncologists (10.1%). Facilities most frequently self-identified as having a centralized (37.7%) program model, followed by identifying as having hybrid (30.4%) and decentralized (20.3%) programs. There was varying implementation of practices to support lung cancer screening, with hybrid and decentralized programs less likely to have lung cancer screening registries, lung cancer screening steering committees, or dedicated lung cancer screening coordinators.ConclusionsAlthough there is overlap between the components of various lung cancer screening program types, centralized programs more frequently implemented practices before the initial screening to support lung cancer screening. This work provides a path for future investigations to identify which lung cancer screening practices are effective to improve lung cancer screening outcomes, which could help inform implementation in settings with limited resources.