Lung Cancer Screening by Race and Ethnicity in an Integrated Health System in Hawaii
| العنوان: | Lung Cancer Screening by Race and Ethnicity in an Integrated Health System in Hawaii |
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| المؤلفون: | Caryn E. S. Oshiro, Timothy B. Frankland, Joanne Mor, Carmen P. Wong, Yannica Theda Martinez, Cheryl K. K. Aruga, Stacey Honda |
| المصدر: | JAMA Network Open |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Male, Lung Neoplasms, Native Hawaiian or Other Pacific Islander, integumentary system, Asian, Incidence, Research, Racial Groups, General Medicine, Middle Aged, Hawaii, White People, Cohort Studies, Online Only, Oncology, Risk Factors, Ethnicity, Humans, Female, Early Detection of Cancer, Aged, Original Investigation |
| الوصف: | Key Points Question Are there racial and ethnic disparities in lung cancer screening (LCS) completion and diagnostic follow-up rates among Asian, Native Hawaiian, and Pacific Islander individuals? Findings In this cohort study of 1030 adults in Hawaii, 838 (81%) completed LCS. There was a 14% to 15% screening completion rate gap between the Korean individuals (94%) and the Filipino (79%), non-Hispanic White (80%), and Pacific Islander groups (79%), although the differences were not significant. Meaning These findings suggest that LCS completion rates may vary among Asian individuals and their subgroups, Native Hawaiian individuals, and Pacific Islander individuals, further highlighting the need to disaggregate these heterogenous groups to adequately understand specific factors that may be associated with LCS program participation. This cohort study examines racial and ethnic differences in lung cancer screening completion and follow-up rates in a multiethnic population in Hawaii. Importance Racial and ethnic differences in lung cancer screening (LCS) completion and follow-up may be associated with lung cancer incidence and mortality rates among high-risk populations. Aggregation of Asian American, Native Hawaiian, and Pacific Islander racial and ethnic groups may mask the true underlying disparities in screening uptake and diagnostic follow-up, creating barriers for targeted, preventive health care. Objective To examine racial and ethnic differences in LCS completion and follow-up rates in a multiethnic population. Design, Setting, and Participants This population-based cohort study was conducted at a health maintenance organization in Hawaii. LCS program participants were identified using electronic medical records from January 1, 2015, to December 31, 2019. Study eligibility requirements included being aged 55 to 79 years, a 30 pack-year smoking history, a current smoker or having quit within the past 15 years, at least 5 years past any lung cancer diagnosis and treatment, and cancer free. Data analysis was performed from June 2019 to October 2020. Exposure Eligible for LCS. Main Outcomes and Measures Screening rates were analyzed by self-reported race and ethnicity and completion of a low-dose computed tomography (LDCT) test. Diagnostic follow-up results were based on the Lung Imaging Reporting and Data System (Lung-RADS) staging system. Results A total of 1030 eligible LCS program members had an order placed; their mean (SD) age was 65.5 (5.8) years, and 633 (61%) were men. The largest racial and ethnic groups were non-Hispanic White (381 participants [37.0%]), Native Hawaiian or part Native Hawaiian (186 participants [18.1%]), and Japanese (146 participants [14.2%]). Men and Filipino, Chinese, Japanese, and non-Hispanic White individuals had a higher proportion of screen orders for LDCT compared with women and individuals of the other racial and ethnic groups. The overall LCS completion rate was 81% (838 participants). There was a 14% to 15% screening completion rate gap among groups. Asian individuals had the highest screening completion rate (266 participants [86%]) followed by Native Hawaiian (149 participants [80%]) and non-Hispanic White individuals (305 participants [80%]), Pacific Islander (50 participants [79%]) individuals, and individuals of other racial and ethnic groups (68 participants [77%]). Within Asian subgroups, Korean (31 participants [94%]) and Japanese (129 participants [88%]) individuals had the highest completion rates followed by Chinese individuals (28 participants [82%]) and Filipino individuals (78 participants [79%]). Of the 54 participants with Lung-RADS stage 3 disease, 93% (50 participants) completed a 6-month surveillance LDCT test; of 37 individuals with Lung-RADS stage 4 disease, 35 (97%) were followed-up for additional procedures. Conclusions and Relevance This cohort study found racial and ethnic disparities in LCS completion rates after disaggregation of Native Hawaiian, Pacific Islander, and Asian individuals and their subgroups. These findings suggest that future research is needed to understand factors that may be associated with LCS completion and follow-up behaviors among these racial and ethnic groups. |
| تدمد: | 2574-3805 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b99fca0378992f2c066a302f248f8326 https://pubmed.ncbi.nlm.nih.gov/35050353 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....b99fca0378992f2c066a302f248f8326 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 25743805 |
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