Uptake of lung cancer screening with low-dose computed tomography in China: A multi-centre population-based study

被引：14

作者：

Cao, Wei ^{[1
]}

Tan, Fengwei ^{[2
]}

Liu, Kuangyu ^{[1
,16
]}

Wu, Zheng ^{[1
]}

Wang, Fei ^{[1
]}

Yu, Yiwen ^{[1
]}

Wen, Yan ^{[1
]}

Qin, Chao ^{[1
]}

Xu, Yongjie ^{[1
]}

Zhao, Liang ^{[1
]}

Tang, Wei ^{[3
]}

Li, Jiang ^{[1
]}

Dong, Xuesi ^{[1
]}

Zheng, Yadi ^{[1
]}

Yang, Zhuoyu ^{[1
]}

Su, Kai ^{[2
]}

Li, Fang ^{[2
]}

Shi, Jufang ^{[1
]}

Ren, Jiansong ^{[1
]}

Liu, Yunyong ^{[4
,5
]}

Yu, Lianzheng ^{[6
]}

Wei, Donghua ^{[7
]}

Dong, Dong ^{[8
]}

Cao, Ji ^{[9
]}

Zhang, Shaokai ^{[10
]}

Yan, Shipeng ^{[11
,12
]}

Wang, Ning ^{[13
]}

Du, Lingbin ^{[14
]}

Chen, Wanqing ^{[1
]}

Li, Ni ^{[1
,15
]}

He, Jie ^{[2
]}

机构：

[1] Chinese Acad Med Sci & Peking Union Med Coll, Natl Canc Ctr, Off Canc Screening, Natl Clin Res Ctr Canc,Canc Hosp, 17 Panjiayuannanli, Beijing 100021, Peoples R China

[2] Chinese Acad Med Sci & Peking Union Med Coll, Natl Canc Ctr, Dept Thorac Surg, Canc Hosp,Natl Clin Res Ctr Canc, 17 Panjiayuannanli, Beijing 100021, Peoples R China

[3] Chinese Acad Med Sci & Peking Union Med Coll, Natl Canc Ctr, Dept Diagnost Radiol, Natl Clin Res Ctr Canc,Canc Hosp, 17 Panjiayuan Nanli, Beijing 100021, Peoples R China

[4] Chinese Acad Med Sci & Peking Union Med Coll, Natl Canc Ctr, Natl Clin Res Ctr Canc, Canc Hosp, Shenzhen 518116, Peoples R China

[5] Chinese Acad Med Sci & Peking Union Med Coll, Shenzhen Hosp, Shenzhen 518116, Peoples R China

[6] Liaoning Ctr Dis Control & Prevent, Shenyang 110005, Peoples R China

[7] Anhui Prov Canc Hosp, Off Canc Prevent & Control, Hefei 230031, Peoples R China

[8] Xuzhou Canc Hosp, Off Canc Prevent & Treatment, Xuzhou 221000, Jiangsu, Peoples R China

[9] Guangxi Med Univ, Canc Prevent & Control Off, Affiliated Tumor Hosp, Nanning 530021, Peoples R China

[10] Zhengzhou Univ, Henan Canc Hosp, Dept Canc Epidemiol, Affiliated Canc Hosp, Zhengzhou 450008, Peoples R China

[11] Cent South Univ, Hunan Canc Hosp, Dept Canc Prevent & Control, Changsha 410000, Peoples R China

[12] Cent South Univ, Affiliated Canc Hosp, Xiangya Sch Med, Changsha 410000, Peoples R China

[13] Peking Univ, Canc Hosp & Inst, Key Lab Carcinogenesis & Translat Res, Minist Educ Beijing,Beijing Off Canc Prevent & Co, Beijing 100142, Peoples R China

[14] Chinese Acad Sci, Dept Canc Prevent, Canc Hosp, Univ Chinese Acad Sci,Zhejiang Canc Hosp,Inst Bas, Hangzhou 310022, Peoples R China

[15] Chinese Acad Med Sci & Peking Union Med Coll, Chinese Acad Med Sci, Key Lab Natl Canc Big Data Anal & Implement, Beijing 100021, Peoples R China

[16] Harvard Univ, Harvard TH Chan Sch Publ Hlth, Dept Environm Hlth, Boston, MA 02115 USA

来源：

ECLINICALMEDICINE | 2022年 / 52卷

关键词：

Lung cancer; Screening; Uptake; Population-based study; China; MORTALITY; TRIAL;

D O I：

10.1016/j.eclinm.2022.101594

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Optimal uptake rates of low-dose computed tomography (LDCT) scans are essential for lung cancer screening (LCS) to confer mortality benefits. We aimed to outline the process model of the LCS programme in China, identify the high-risk individuals with low uptake based on a prospective multi-centre population-based cohort, and further explore associated structural characteristics. Methods A total of 221,955 individuals at high-risk for lung cancer from the National Lung Cancer Screening cohort were included. The logistic regression model was performed to identify the individual characteristics associated with the uptake of LCS, defined as whether the high-risk individual undertook LDCT scans in designated hospitals within six months following the initial risk assessment. The linear regression model was adopted to explore the structural characteristics associated with the uptake rates in 186 communities. Findings The overall uptake rate was 33.0%. The uptake rate was negatively correlated with the incidence of advanced-stage lung cancer (Pearson's coefficient -0.88, p-value 0.0007). Multivariable regression models found that lower uptake rates were associated with males (OR 0.88, 95%CI 0.85-0.91), current smokers (OR 0.93, 95%CI 0.90-0.96), individuals with depressive symptoms (OR 0.92, 95%CI 0.90-0.94), and the structural characteristics, including longer structural delays in initiating LDCT scans (30-90 days vs. =14 days: beta -7.17, 95%CI -12.76 similar to -1.57; >90 days vs. <= 14 days: beta -13.69, 95%CI -24.61 similar to -2.76), no media-assisted publicity (beta -6.43, 95%CI -11.26 similar to -1.60), and no navigation assistance (beta -5.48, 95%CI -10.52 similar to -0.44). Interpretation: Multifaceted interventions are recommended, which focus on poor-uptake individuals and integrate the 'assessment-to-timely-screening' approach to minimise structural delays, media publicity, and a navigation assistance along the centralised screening pathway. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.

引用

页数：13

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