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

项目总结/摘要 有必要了解国家肺筛查试验（NLST）和美国预试验的结果如何。 风险服务工作组（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。鉴于高发病率和死亡率， 肺癌，发展证据的效用筛选测试，可以降低肺癌死亡率将 可能会显着改善公共卫生。我们的长期目标是考察交期、质量 利用前瞻性人群肺癌筛查在北卡罗来纳州的结果 筛选数据，捕获患者、放射科医生和病理学信息，以告知临床实践。的 本申请的目的是评估中期肺癌筛查的差异程度 结果是存在的。我们计划透过以下四个具体目标来达致这个目标：（1）遏止- 挖掘放射科医师使用肺部影像报告和数据系统（Lung-RADS）的一致性 评估代码和后续建议与美国放射学会（ACR）指南; (2)根据患者的社会人口统计学和危险因素评估LDCT肺癌筛查的召回率; (3)按患者社会性别比较肺癌筛查结果阳性后的随访率， 人口统计学和风险因素;（4）在肺癌筛查数据和肺癌之间建立数据联系- 来自北卡罗来纳州中央癌症登记处（NCCCR）的cer结果，以检查假阳性率。与 USPSTF建议LDCT用于高危人群的肺癌筛查，越来越需要 监测学术中心和社区实践开始采用这项技术时的筛查经验， 戈伊。这是一项创新性研究，使用基于人口的登记发展中的既定方法， 探索一个新兴的临床相关的癌症筛查领域，其数据有限。拟议研究 是重要的，因为它将提供证据，肺癌筛查与LDCT在一般人群， 告知肺癌筛查的交付，质量和结果，因为它扩散到临床实践中。

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.