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

描述(由申请人提供)：我们对国家肺部筛查试验(NLST)的结果将如何影响普通人群中使用低剂量计算机断层扫描(LDCT)进行肺癌筛查的了解存在空白。鉴于肺癌的高发病率和死亡率，开发证据表明筛查测试可以降低肺癌死亡率，这可能会显著改善公共卫生。长期目标是通过创建一个基于预期人群的登记来检查全美肺癌筛查的交付和质量，该登记收集有关使用LDCT进行筛查的患者、放射科医生和结果信息。该应用程序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在该州进行肺癌筛查的普及程度。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)在该州的放射学实践中检查使用低密度CT进行肺癌筛查的可用性。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，以便从患者和放射科医生那里获取筛查信息。通过对CT认可的放射科设施进行调查，我们将调查该州目前正在进行筛查的设施的特点，并确定在随后的扩展阶段可以合作的设施。目前，LDCT用于肺癌筛查的建议褒贬不一，但随着学术中心和社区实践开始采用这项技术对高危人群进行早期检测，监测筛查体验的需求越来越大。这是一项创新的先导性研究，它使用基于人口的登记发展和调查方法中的既定方法来探索一个正在出现的临床相关的癌症筛查领域，这一领域受到了广泛的辩论。这项拟议的研究意义重大，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捕获系统，该系统将在该技术普及到社区时告知肺癌筛查的交付和质量。

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.