Uptake of Lung Cancer Screening CT After a Provider Order for Screening in the PROSPR-Lung Consortium.

Autor: Neslund-Dudas C; Henry Ford Health System and Henry Ford Cancer Institute, Detroit, MI, USA. cdudas1@hfhs.org.; Department of Public Health Sciences, Henry Ford Health System, One Ford Place, Suite 3E, Detroit, MI, 48202, USA. cdudas1@hfhs.org., Tang A; Henry Ford Health System and Henry Ford Cancer Institute, Detroit, MI, USA., Alleman E; Henry Ford Health System and Henry Ford Cancer Institute, Detroit, MI, USA., Zarins KR; Henry Ford Health System and Henry Ford Cancer Institute, Detroit, MI, USA., Li P; Henry Ford Health System and Henry Ford Cancer Institute, Detroit, MI, USA., Simoff MJ; Henry Ford Health System and Henry Ford Cancer Institute, Detroit, MI, USA., Lafata JE; Henry Ford Health System and Henry Ford Cancer Institute, Detroit, MI, USA.; UNC Eshelman School of Pharmacy and Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA., Rendle KA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Hartman ANB; Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA., Honda SA; Center for Integrated Healthcare Research, Kaiser Permanente Hawaii, Honolulu, HI, USA.; Hawaii Permanente Medical Group, Honolulu, HI, USA., Oshiro C; Center for Integrated Healthcare Research, Kaiser Permanente Hawaii, Honolulu, HI, USA., Olaiya O; Marshfield Clinic Research Institute, Marshfield, WI, USA., Greenlee RT; Marshfield Clinic Research Institute, Marshfield, WI, USA., Vachani A; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Ritzwoller DP; Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA.
Jazyk: angličtina
Zdroj: Journal of general internal medicine [J Gen Intern Med] 2024 Feb; Vol. 39 (2), pp. 186-194. Date of Electronic Publication: 2023 Oct 02.
DOI: 10.1007/s11606-023-08408-9
Abstrakt: Background: Uptake of lung cancer screening (LCS) has been slow with less than 20% of eligible people who currently or formerly smoked reported to have undergone a screening CT.
Objective: To determine individual-, health system-, and neighborhood-level factors associated with LCS uptake after a provider order for screening.
Design and Subjects: We conducted an observational cohort study of screening-eligible patients within the Population-based Research to Optimize the Screening Process (PROSPR)-Lung Consortium who received a radiology referral/order for a baseline low-dose screening CT (LDCT) from a healthcare provider between January 1, 2015, and June 30, 2019.
Main Measures: The primary outcome is screening uptake, defined as LCS-LDCT completion within 90 days of the screening order date.
Key Results: During the study period, 18,294 patients received their first order for LCS-LDCT. Orders more than doubled from the beginning to the end of the study period. Overall, 60% of patients completed screening after receiving their first LCS-LDCT order. Across health systems, uptake varied from 41 to 87%. In both univariate and multivariable analyses, older age, male sex, former smoking status, COPD, and receiving care in a centralized LCS program were positively associated with completing LCS-LDCT. Unknown insurance status, other or unknown race, and lower neighborhood socioeconomic status, as measured by the Yost Index, were negatively associated with screening uptake.
Conclusions: Overall, 40% of patients referred for LCS did not complete a LDCT within 90 days, highlighting a substantial gap in the lung screening care pathway, particularly in decentralized screening programs.
(© 2023. The Author(s), under exclusive licence to Society of General Internal Medicine.)
Databáze: MEDLINE
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