Capacity constraints and disparities in the scale-up of lung cancer CT screening

扩大肺癌CT筛查的能力限制和差异

• 批准号: 8683338
• 负责人: Fabrice Smieliauskas
• 金额: $ 7.9万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8683338
• 关键词: Address; Adult; Advisory Committees; Age; Area; Attention; Cessation of life; Clinical; Clinical Trials; Colorectal Cancer; Country; Data; Dimensions; Dose; Effectiveness; Evidence based intervention; Face; Funding; Future; Geographic Distribution; Geographic Information Systems; Health; Health system; Intervention; Lead; Life; Link; Lung; Malignant Neoplasms; Malignant neoplasm of lung; Mammography; Maps; Measures; Outcome; Population; Positioning Attribute; Preventive; Process; Public Health; Public Health Practice; Recommendation; Recording of previous events; Relative (related person); Reporting; Research; Rural; Screening for cancer; Services; Smoker; Smoking; Statistical Models; Subgroup; Surveys; Time; Tomography, Computed, Scanners; Translations; United States; United States Agency for Healthcare Research and Quality; United States National Institutes of Health; Visual; X-Ray Computed Tomography; anticancer research; attributable mortality; base; clinical practice; colorectal cancer screening; evidence base; geographic difference; lung cancer screening; malignant breast neoplasm; mortality; population based; programs; public health relevance; scale up; screening; socioeconomics

DESCRIPTION (provided by applicant): Thousands of avoidable cancer deaths occur every year in the United States because evidence-based cancer screening interventions get "lost in translation" in the process between discovery and widespread public health and clinical practice. Lung cancer screening holds great potential to reduce cancer deaths, given the recent evidence of effectiveness of screening and the numbers of deaths attributable to lung cancer, but there has been little study of how capacity constraints in the health system might slow these efforts, as they have in screening for other cancers. To address how capacity might influence the scale-up of lung cancer screening, we propose to generate estimates of geographic variation in the number of heavy smokers from 2010-2011 population-based surveys, as well as measures of local clinical and public health system capacity derived from a diverse set of administrative and survey data from 2008-2012 on facilities, CT scanners, health workers, and public health programs. Superimposing these data maps of capacity and of the screening population, we specifically intend: 1. using multiple dimensions of lung screening capacity, to determine the proportion of the nation's heavy smokers living in areas that face capacity constraints to scaling up a program of lung cancer screening. This would reflect the geographic distribution of screening capacity and of the population of heavy smokers, as well as differences between the two. 2. To identify potential disparities in access to lung cancer screening that may emerge across racial, socioeconomic, rural/urban, and educational lines due to the geographic variation in capacity constraints. Disparities in access to screening for other cancers can be substantial, and may be intensified in lung cancer due to higher smoking rates among vulnerable subgroups.

在美国，每年发生数千例可避免的癌症死亡，因为循证癌症筛查干预措施在发现与广泛的公共卫生和临床实践之间的过程中“迷失在翻译中”。鉴于最近的证据表明筛查的有效性和肺癌导致的死亡人数，肺癌筛查在减少癌症死亡方面具有巨大的潜力，但很少有研究表明卫生系统的能力限制如何减缓这些努力，就像他们在筛查其他癌症方面所做的那样。 为了解决能力如何影响肺癌筛查的扩大，我们建议从2010-2011年基于人口的调查中估计重度吸烟者数量的地理差异，以及从2008-2012年关于设施，CT扫描仪，卫生工作者，和公共卫生项目。叠加这些容量和筛查人群的数据图，我们特别打算：1。使用多个维度的肺筛查能力，以确定国家的重度吸烟者的比例，生活在面临能力限制的地区，以扩大肺癌筛查计划。这将反映筛查能力和重度吸烟者人口的地理分布，以及两者之间的差异。2.确定由于能力限制的地理差异而可能出现的跨种族，社会经济，农村/城市和教育线的肺癌筛查的潜在差异。在获得其他癌症筛查方面的差距可能很大，而且由于弱势亚群中吸烟率较高，肺癌可能会加剧。