Evaluating Lung Cancer Screening Patterns and Outcomes through a North Carolina Registry

项目概要/摘要 有必要了解国家肺部筛查试验 (NLST) 和美国预筛查试验的结果如何 通风服务工作组 (USPSTF) 指南将影响低剂量计算机断层扫描的使用 （LDCT）用于一般人群的肺癌筛查。鉴于该病的高发病率和死亡率 肺癌，开发证据证明筛查测试可以降低肺癌死亡率 可能会导致公共卫生的显着改善。我们的长期目标是检验交期、质量 北卡罗来纳州利用前瞻性人群肺癌进行肺癌筛查的结果 捕获患者、放射科医生和病理学信息的筛选数据，为临床实践提供信息。的 该应用程序的目的是评估中间肺癌筛查的差异程度 结果是存在的。我们计划通过实现以下四个具体目标来实现这一目标：（1）阻止 挖掘放射科医生使用肺部成像报告和数据系统（Lung-RADS）之间的协议 符合美国放射学会 (ACR) 指南的评估代码和后续建议； (2) 根据患者的社会人口特征和危险因素评估 LDCT 肺癌筛查的召回率； (3) 比较肺癌筛查测试结果呈阳性后患者社会群体的随访率 人口统计和风险因素； (4) 进行肺癌筛查数据与肺癌的数据联动—— 北卡罗来纳州中央癌症登记处 (NCCCR) 的 cer 结果用于检查假阳性率。与 USPSTF 建议使用 LDCT 对高危人群进行肺癌筛查，因此越来越需要 随着学术中心和社区实践开始采用这项技术，监控筛查体验 吉。这是一项创新研究，使用基于人口的登记系统开发中的既定方法来消除 探索一个新兴的临床相关癌症筛查领域，其数据有限。拟议的研究 意义重大，因为它将提供在一般人群中使用 LDCT 进行肺癌筛查的证据 随着肺癌筛查扩散到临床实践中，为肺癌筛查的实施、质量和结果提供信息。

PROJECT SUMMARY/ABSTRACT There is a need to understand how the results of the National Lung Screening Trial (NLST) and the U.S. Pre- ventive Services Task Force (USPSTF) guidelines 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. Our long-term goal is to examine the delivery, quality and outcomes of lung cancer screening in North Carolina by utilizing prospective population-based lung cancer screening data that captures patient, radiologist, and pathology information to inform clinical practice. The objective of this application is to evaluate the extent to which disparities in intermediate lung cancer screening outcomes exist. We plan to accomplish this objective by pursuing the following four specific aims: (1) Deter- mine the agreement between radiologists' use of the lung imaging reporting and data system (Lung-RADS) assessment code and follow-up recommendations with the American College of Radiology (ACR) guidelines; (2) Evaluate recall rates of lung cancer screening with LDCT by patient socio-demographics and risk factors; (3) Compare rates of follow-up receipt after a positive lung cancer screening test result by patient socio- demographics and risk factors; (4) Perform a data linkage between lung cancer screening data and lung can- cer outcomes from the North Carolina Central Cancer Registry (NCCCR) to examine false positive rates. With the USPSTF recommending LDCT for lung cancer screening in high-risk individuals, there is a growing need to monitor the screening experience as academic centers and community practices begin to adopt this technolo- gy. This is an innovative study that uses established methods in population-based registry development to ex- plore an emerging clinically relevant cancer screening area for which limited data exist. The proposed research is significant because it will provide evidence on lung cancer screening with LDCT in a general population to inform the delivery, quality, and outcomes of lung cancer screening as it diffuses into clinical practice.