Impact of Mass Screening Using Chest X-Ray on Mortality Reduction and Treatment Adherence Among Pulmonary Tuberculosis Patients.

Autor:	Baek JY; Cancer Research Institute, Seoul National University, Seoul, Korea.; Interdisciplinary Program in Cancer Biology Major, Seoul National University College of Medicine, Seoul, Korea.; Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Korea.; Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea., Kazmi SZ; Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea., Lee H; Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea., Hwang Y; Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea., Park SJ; National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea., Shin MH; Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea., Lee J; National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea., Choi H; Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Korea., Shin A; Cancer Research Institute, Seoul National University, Seoul, Korea.; Interdisciplinary Program in Cancer Biology Major, Seoul National University College of Medicine, Seoul, Korea.; Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Korea.; Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea. shinaesun@snu.ac.kr.
Jazyk:	angličtina
Zdroj:	Journal of Korean medical science [J Korean Med Sci] 2024 Nov 25; Vol. 39 (45), pp. e286. Date of Electronic Publication: 2024 Nov 25.
DOI:	10.3346/jkms.2024.39.e286
Abstrakt:	Background: Evaluate the impact of chest X-ray (CXR) screening on mortality and treatment adherence by comparing pulmonary tuberculosis (PTB) cases detected through screening and those routinely diagnosed at healthcare facilities. Methods: A retrospective analysis of 10% randomly sampled National Health Insurance Service claims data assessed PTB cases diagnosed during 2004-2020. Patients were categorized as 'screening-detected (ACF, active case finding)' or 'routinely detected (PCF, passive case finding)' based on CXR screening history. Cox proportional hazards model determined the association between screening and all-cause or tuberculosis (TB)-specific mortality. Treatment adherence was also measured. Results: Among 84,828 PTB patients, 18.76% were ACF (15,916), and 81.24% were PCF (68,912). ACF exhibited lower risks in all-cause mortality (adjusted hazard ratio [aHR], 0.70; 95% confidence interval [CI], 0.67-0.73) and TB-specific mortality (aHR, 0.38; 95% CI, 0.32-0.46) compared to PCF. In the ACF group, 91.39% initiated anti-TB treatment, with 45.99% adherence. For PCF, 92.87% initiated treatment, and only 45.44% were adherent. Conclusion: Individuals undergoing CXR screening have a lower risk of both all-cause and TB-specific mortality compared to PCF, but treatment adherence is similar between the two groups, emphasizing the need to improve the linkage between screening, diagnosis, and treatment for the screened population. Competing Interests: The authors have no potential conflicts of interest to disclose. (© 2024 The Korean Academy of Medical Sciences.)
Databáze:	MEDLINE
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