Uptake of invitations to a lung health check offering low-dose CT lung cancer screening among an ethnically and socioeconomically diverse population at risk of lung cancer in the UK (SUMMIT): a prospective, longitudinal cohort study.

Autor:	Dickson JL; Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK., Hall H; Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK., Horst C; Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK., Tisi S; Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK., Verghese P; Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK., Mullin AM; Cancer Research UK and UCL Cancer Trials Centre, University College London, London, UK., Teague J; Cancer Research UK and UCL Cancer Trials Centre, University College London, London, UK., Farrelly L; Cancer Research UK and UCL Cancer Trials Centre, University College London, London, UK., Bowyer V; University College London Hospitals NHS Foundation Trust, London, UK., Gyertson K; University College London Hospitals NHS Foundation Trust, London, UK., Bojang F; University College London Hospitals NHS Foundation Trust, London, UK., Levermore C; University College London Hospitals NHS Foundation Trust, London, UK., Anastasiadis T; Tower Hamlets Clinical Commissioning Group, London, UK., McCabe J; Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK., Navani N; Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK; University College London Hospitals NHS Foundation Trust, London, UK., Nair A; University College London Hospitals NHS Foundation Trust, London, UK., Devaraj A; Royal Brompton and Harefield NHS Trust, London, UK; National Heart and Lung Institute, Imperial College London, London, UK., Hackshaw A; Cancer Research UK and UCL Cancer Trials Centre, University College London, London, UK., Quaife SL; Wolfson Institute of Population Health, Queen Mary University of London, London, UK., Janes SM; Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK. Electronic address: s.janes@ucl.ac.uk.
Jazyk:	angličtina
Zdroj:	The Lancet. Public health [Lancet Public Health] 2023 Feb; Vol. 8 (2), pp. e130-e140.
DOI:	10.1016/S2468-2667(22)00258-4
Abstrakt:	Background: Lung cancer screening with low-dose CT reduces lung cancer mortality, but screening requires equitable uptake from candidates at high risk of lung cancer across ethnic and socioeconomic groups that are under-represented in clinical studies. We aimed to assess the uptake of invitations to a lung health check offering low-dose CT lung cancer screening in an ethnically and socioeconomically diverse cohort at high risk of lung cancer. Methods: In this multicentre, prospective, longitudinal cohort study (SUMMIT), individuals aged 55-77 years with a history of smoking in the past 20 years were identified via National Health Service England primary care records at practices in northeast and north-central London, UK, using electronic searches. Eligible individuals were invited by letter to a lung health check offering lung cancer screening at one of four hospital sites, with non-responders re-invited after 4 months. Individuals were excluded if they had dementia or metastatic cancer, were receiving palliative care or were housebound, or declined research participation. The proportion of individuals invited who responded to the lung health check invitation by telephone was used to measure uptake. We used univariable and multivariable logistic regression analyses to estimate associations between uptake of a lung health check invitation and re-invitation of non-responders, adjusted for sex, age, ethnicity, smoking, and deprivation score. This study was registered prospectively with ClinicalTrials.gov, NCT03934866. Findings: Between March 20 and Dec 12, 2019, the records of 2 333 488 individuals from 251 primary care practices across northeast and north-central London were screened for eligibility; 1 974 919 (84·6%) individuals were outside the eligible age range, 7578 (2·1%) had pre-existing medical conditions, and 11 962 (3·3%) had opted out of particpation in research and thus were not invited. 95 297 individuals were eligible for invitation, of whom 29 545 (31·0%) responded. Due to the COVID-19 pandemic, re-invitation letters were sent to only a subsample of 4594 non-responders, of whom 642 (14·0%) responded. Overall, uptake was lower among men than among women (odds ratio [OR] 0·91 [95% CI 0·88-0·94]; p<0·0001), and higher among older age groups (1·48 [1·42-1·54] among those aged 65-69 years vs those aged 55-59 years; p<0·0001), groups with less deprivation (1·89 [1·76-2·04] for the most vs the least deprived areas; p<0·0001), individuals of Asian ethnicity (1·14 [1·09-1·20] vs White ethnicity; p<0·0001), and individuals who were former smokers (1·89 [1·83-1·95] vs current smokers; p<0·0001). When ethnicity was subdivided into 16 groups, uptake was lower among individuals of other White ethnicity than among those with White British ethnicity (0·86 [0·83-0·90]), whereas uptake was higher among Chinese, Indian, and other Asian ethnicities than among those with White British ethnicity (1·33 [1·13-1·56] for Chinese ethnicity; 1·29 [1·19-1·40] for Indian ethnicity; and 1·19 [1·08-1·31] for other Asian ethnicity). Interpretation: Inviting eligible adults for lung health checks in areas of socioeconomic and ethnic diversity should achieve favourable participation in lung cancer screening overall, but inequalities by smoking, deprivation, and ethnicity persist. Reminder and re-invitation strategies should be used to increase uptake and the equity of response. Funding: GRAIL. Competing Interests: Declaration of interests JLD, CH, ST, HH, and PV were employed by University College London (UCL) as clinical research fellows through SUMMIT Study funding provided by GRAIL. SMJ has received travel expenses from AstraZeneca, BARD1 Bioscience, Optellum, Jansen, Takeda, Evidera, and Achilles Therapeutics for participation on advisory boards; has received honoraria for lectures from Chiesi; and has received travel expenses from AstraZeneca for a US conference. AH has received one honorarium for an advisory board meeting for GRAIL; has received consulting fees from Evidera (for a GRAIL-initiated project); and has previously owned shares in Illumina. NN has received honoraria for advisory, education, and consultancy work from Amgen, AstraZeneca, Bristol-Meyers Squibb, Guardant Health, Janssen, Lilly & Co, Merck Sharp & Dohme, Olympus, Oncimmune, OncLive, PeerVoice, Pfizer, and Takeda, all outside of the submitted work. AN has received consulting fees from Aidence BV, Faculty Science Limited, and MSD; and has received expenses for travelling to a conference from Takeda. A-MM, JT, LF, VB, KG, FB, CL, TA, JM, AD, and SLQ declare no competing interests. (Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu