Developing a Lung Cancer Screening Registry in a State with a High Smoking Rate

描述（由申请人提供）：我们对国家肺筛查试验（NLST）的结果将如何影响低剂量计算机断层扫描（LDCT）在普通人群中用于肺癌筛查的知识存在差距。鉴于肺癌的高发病率和死亡率，开发关于可以降低肺癌死亡率的筛查测试的实用性的证据可能会导致公共卫生的显著改善。长期目标是通过创建一个前瞻性的基于人群的登记系统来检查整个美国肺癌筛查的交付和质量，该登记系统捕获了关于使用LDCT进行筛查的患者，放射科医生和结果信息。本申请的目的是对基于人群的肺癌筛查登记进行试点测试，并确定LDCT肺癌筛查在全州范围内的扩散程度。我们计划通过追求以下两个具体目标来实现这些目标：（1）开发和实施建立基于人群的肺癌筛查登记所需的工具;（2）检查该州放射学实践中LDCT肺癌筛查的可用性。这项研究将 重点是开发和实施数据收集要素，以及建立一个安全的数据输入系统，用于从患者和放射科医生那里获取筛查信息。通过对CT认证的放射学设施进行调查，我们将调查目前在该州进行筛查的设施的特点，并确定在随后的扩展阶段进行合作的设施。目前，LDCT用于肺癌筛查的建议是混合的，但随着学术中心和社区实践开始采用该技术用于高危人群的早期检测，越来越需要监测筛查经验。这是一项创新的试点研究，使用基于人口的登记发展和调查方法中的既定方法，探索一个正在广泛讨论的新兴临床相关癌症筛查领域。这项拟议中的研究意义重大，因为它将提供关于在非临床试验人群中使用LDCT进行肺癌筛查的初步数据，并将创建一个持续数据采集系统，该系统将为肺癌筛查的交付和质量提供信息，因为这项技术扩散到社区。

DESCRIPTION (provided by applicant): There is a gap in our knowledge of how the results of the National Lung Screening Trial (NLST) will impact the use of low dose computed tomography (LDCT) for lung cancer screening in the general population. Given the high incidence and mortality rates of lung cancer, developing evidence on the utility of a screening test that can reduce lung cancer mortality will likely lead to a significant improvement in public health. The long-term goal is to examine the delivery and quality of lung cancer screening across the U.S. by creating a prospective population based registry that captures patient, radiologist, and outcome information on the use of LDCT for screening. The objective of this application is to pilot test a population based lung cancer screening registry and determine the extent to which lung cancer screening with LDCT has diffused across the state. We plan to accomplish these objectives by pursuing the following two specific aims: (1) Develop and implement the tools required to establish a population-based lung cancer screening registry; and (2) Examine the availability of lung cancer screening with LDCT among radiology practices in the state. The study will focus on developing and implementing data collection elements as well as constructing a secure data entry system for capturing screening information from patients and radiologists. By conducting a survey of CT accredited radiology facilities we will investigate the characteristics o facilities currently performing screening in the state and also identify facilities for partnershipin the subsequent expansion phase. Currently, recommendations for LDCT for lung cancer screening are mixed, yet there is a growing need to monitor the screening experience as academic centers and community practices begin to adopt this technology for early detection in high-risk groups. This is an innovative pilot study that uses established methods in population based registry development and survey methodology to explore an emerging clinically relevant cancer screening area which is widely debated. The proposed research is significant because it will provide preliminary data on the use of LDCT for lung cancer screening in the non-clinical trial population and will also create a system for ongoing data capture that will inform the delivery and quality of lung cancer screening as this technology diffuses into the community.