1
|
Bandi P, Star J, Ashad-Bishop K, Kratzer T, Smith R, Jemal A. Lung Cancer Screening in the US, 2022. JAMA Intern Med 2024:2819820. [PMID: 38856988 PMCID: PMC11165414 DOI: 10.1001/jamainternmed.2024.1655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 03/20/2024] [Indexed: 06/11/2024]
Abstract
Importance The US Preventive Services Task Force (USPSTF) recommends annual lung cancer screening (LCS) with low-dose computed tomography in high-risk individuals (age 50-80 years, ≥20 pack-years currently smoking or formerly smoked, and quit <15 years ago) for early detection of LC. However, representative state-level LCS data are unavailable nationwide. Objective To estimate the contemporary prevalence of up-to-date (UTD) LCS in the US nationwide and across the 50 states and the District of Columbia. Design, Setting, and Participants This cross-sectional study used data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) population-based, nationwide, state-representative survey for respondents aged 50 to 79 years who were eligible for LCS according to the 2021 USPSTF eligibility criteria. Data analysis was performed from October 1, 2023, to March 20, 2024. Main Outcomes and Measures The main outcome was self-reported UTD-LCS (defined as past-year) prevalence according to the 2021 USPSTF eligibility criteria in respondents aged 50 to 79 years. Adjusted prevalence ratios (APRs) and 95% CIs compared differences. Results Among 25 958 sample respondents eligible for LCS (median [IQR] age, 62 [11] years), 61.5% reported currently smoking, 54.4% were male, 64.4% were aged 60 years or older, and 53.0% had a high school education or less. The UTD-LCS prevalence was 18.1% overall, but varied across states (range, 9.7%-31.0%), with relatively lower levels in southern states characterized by high LC mortality burden. The UTD-LCS prevalence increased with age (50-54 years: 6.7%; 70-79 years: 27.1%) and number of comorbidities (≥3: 24.6%; none: 8.7%). A total of 3.7% of those without insurance and 5.1% of those without a usual source of care were UTD with LCS, but state-level Medicaid expansions (APR, 2.68; 95% CI, 1.30-5.53) and higher screening capacity levels (high vs low: APR, 1.93; 95% CI, 1.36-2.75) were associated with higher UTD-LCS prevalence. Conclusions and Relevance This study of data from the 2022 BRFSS found that the overall prevalence of UTD-LCS was low. Disparities were largest according to health care access and geographically across US states, with low prevalence in southern states with high LC burden. The findings suggest that state-based initiatives to expand access to health care and screening facilities may be associated with improved LCS rates and reduced disparities.
Collapse
Affiliation(s)
- Priti Bandi
- Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Jessica Star
- Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Kilan Ashad-Bishop
- Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Tyler Kratzer
- Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Robert Smith
- Center for Cancer Screening, American Cancer Society, Atlanta, Georgia
| | - Ahmedin Jemal
- Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
| |
Collapse
|
2
|
Richmond J, Fernandez JR, Bonnet K, Sellers A, Schlundt DG, Forde AT, Wilkins CH, Aldrich MC. Patient Lung Cancer Screening Decisions and Environmental and Psychosocial Factors. JAMA Netw Open 2024; 7:e2412880. [PMID: 38819825 PMCID: PMC11143466 DOI: 10.1001/jamanetworkopen.2024.12880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/17/2024] [Indexed: 06/01/2024] Open
Abstract
Importance Screening for lung cancer using low-dose computed tomography is associated with reduced lung cancer-specific mortality, but uptake is low in the US; understanding how patients make decisions to engage with lung cancer screening is critical for increasing uptake. Prior research has focused on individual-level psychosocial factors, but environmental factors (eg, historical contexts that include experiencing racism) and modifying factors-those that can be changed to make it easier or harder to undergo screening-also likely affect screening decisions. Objective To investigate environmental, psychosocial, and modifying factors influencing lung cancer screening decision-making and develop a conceptual framework depicting relationships between these factors. Design, Setting, and Participants This multimethod qualitative study was conducted from December 2021 to June 2022 using virtual semistructured interviews and 4 focus groups (3-4 participants per group). All participants met US Preventive Services Task Force eligibility criteria for lung cancer screening (ie, age 50-80 years, at least a 20 pack-year smoking history, and either currently smoke or quit within the past 15 years). Screening-eligible US participants were recruited using an online panel. Main Outcomes and Measures Key factors influencing screening decisions (eg, knowledge, beliefs, barriers, and facilitators) were the main outcome. A theory-informed, iterative inductive-deductive approach was applied to analyze data and develop a conceptual framework summarizing results. Results Among 34 total participants (interviews, 20 [59%]; focus groups, 14 [41%]), mean (SD) age was 59.1 (4.8) years and 20 (59%) identified as female. Half had a household income below $20 000 (17 [50%]). Participants emphasized historical and present-day racism as critical factors contributing to mistrust of health care practitioners and avoidance of medical procedures like screening. Participants reported that other factors, such as public transportation availability, also influenced decisions. Additionally, participants described psychosocial processes involved in decisions, such as perceived screening benefits, lung cancer risk appraisal, and fear of a cancer diagnosis or harmful encounters with practitioners. In addition, participants identified modifying factors (eg, insurance coverage) that could make receiving screening easier or harder. Conclusions and Relevance In this qualitative study of patient lung cancer screening decisions, environmental, psychosocial, and modifying factors influenced screening decisions. The findings suggest that systems-level interventions, such as those that help practitioners understand and discuss patients' prior negative health care experiences, are needed to promote effective screening decision-making.
Collapse
Affiliation(s)
- Jennifer Richmond
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Jessica R. Fernandez
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
- NORC at the University of Chicago, Bethesda, Maryland
| | - Kemberlee Bonnet
- Department of Psychology, Vanderbilt University, Nashville, Tennessee
- Qualitative Research Core, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ashley Sellers
- Department of Psychology, Vanderbilt University, Nashville, Tennessee
- Qualitative Research Core, Vanderbilt University Medical Center, Nashville, Tennessee
| | - David G. Schlundt
- Department of Psychology, Vanderbilt University, Nashville, Tennessee
- Qualitative Research Core, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Allana T. Forde
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Consuelo H. Wilkins
- Division of Geriatric Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Melinda C. Aldrich
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| |
Collapse
|
3
|
Odole IP, Andersen M, Richman IB. Digital Interventions to Support Lung Cancer Screening: A Systematic Review. Am J Prev Med 2024; 66:899-908. [PMID: 38246408 DOI: 10.1016/j.amepre.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 01/10/2024] [Accepted: 01/10/2024] [Indexed: 01/23/2024]
Abstract
INTRODUCTION Lung cancer remains a leading cause of cancer-related deaths globally. Lung cancer screening (LCS) with low-dose computed tomography (LDCT) can reduce lung cancer mortality, but its adoption in the U.S. has been limited. Digital interventions have the potential to improve uptake of LCS. This systematic review aims to summarize the evidence for the effectiveness of digital interventions in promoting LCS. METHODS A systematic search of three electronic databases (PubMed, Embase, and Medline) was conducted to identify studies published between January 2014 and May 2023. Studies were reviewed and abstracted between February 2023 and July 2023. Outcomes related to knowledge, decision-making and screening were measured. Study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. RESULTS Of 1,979 screened articles, 30 studies were included in this review. Digital interventions evaluated included decision aids (n=20), electronic health record (EHR)-based interventions (n=7), social media campaigns and mobile applications (n=3). Decision aids were the most commonly studied digital interventions, with most studies showing improved knowledge (13/13) and reduced decisional conflict (7/9) but most did not show a substantial change in screening use. Fewer studies tested clinician-facing or multi-level interventions. DISCUSSION Digital interventions, particularly decision aids, have shown promise in improving knowledge and the quality of decision-making around LCS. However, few interventions have been shown to substantially alter screening behavior and few clinician-facing or multi-level interventions have been rigorously tested. Further research is needed to develop effective tools for engaging patients in LCS, to compare the efficacy of different interventions, and evaluate implementation strategies in diverse healthcare settings.
Collapse
Affiliation(s)
| | | | - Ilana B Richman
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.
| |
Collapse
|
4
|
Saito T, Imahashi K, Yamaki C. Use of General Health Examination and Cancer Screening among People with Disability Who Need Support from Others: Analysis of the 2016 Comprehensive Survey of Living Conditions in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:219. [PMID: 38397708 PMCID: PMC10888656 DOI: 10.3390/ijerph21020219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/07/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
Research on preventive healthcare services among people with disability in Japan is scarce. This study aimed to (1) examine the relationship between disability and the use of general health examination (GHE) and cancer screening (lung, gastric, colorectal, breast and cervical cancer) and (2) explore the reasons for not using GHE. This cross-sectional study used secondary data from individuals aged 20-74 years (n = 15,294) from the Comprehensive Survey of Living Conditions of 2016. Binomial logistic regression analysis was conducted to examine the relationship between disability and non-participation in preventive services. In addition, a descriptive analysis was conducted to explore the reasons for non-participation in GHE. Consequently, disability was identified as an independently associated factor for non-participation in GHE (odds ratios (OR): 1.73; 95% confidence interval (95%CI): 1.14-2.62) and screening for colorectal (OR: 1.78; 95%CI: 1.08-2.94), gastric (OR: 2.27; 95%CI: 1.27-4.05), cervical (OR: 2.12; 95%CI: 1.04-4.32) and breast cancer (OR: 2.22; 95%CI: 1.04-4.72), controlling for confounding factors. The most dominant reason for non-participation was "I can go to see the doctor anytime, if I am worried (25/54, 46.3%)." Our findings imply the existence of disability-based disparity in preventive healthcare service use in Japan.
Collapse
Affiliation(s)
- Takashi Saito
- Department of Social Rehabilitation, Research Institute of National Rehabilitation Center for Persons with Disabilities, 4-1 Namiki, Tokorozawa 359-8555, Japan;
| | - Kumiko Imahashi
- Department of Social Rehabilitation, Research Institute of National Rehabilitation Center for Persons with Disabilities, 4-1 Namiki, Tokorozawa 359-8555, Japan;
| | - Chikako Yamaki
- Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji, Chuou 104-0045, Japan;
| |
Collapse
|
5
|
Poon C, Wilsdon T, Sarwar I, Roediger A, Yuan M. Why is the screening rate in lung cancer still low? A seven-country analysis of the factors affecting adoption. Front Public Health 2023; 11:1264342. [PMID: 38026274 PMCID: PMC10666168 DOI: 10.3389/fpubh.2023.1264342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Strong evidence of lung cancer screening's effectiveness in mortality reduction, as demonstrated in the National Lung Screening Trial (NLST) in the US and the Dutch-Belgian Randomized Lung Cancer Screening Trial (NELSON), has prompted countries to implement formal lung cancer screening programs. However, adoption rates remain largely low. This study aims to understand how lung cancer screening programs are currently performing. It also identifies the barriers and enablers contributing to adoption of lung cancer screening across 10 case study countries: Canada, China, Croatia, Japan, Poland, South Korea and the United States. Adoption rates vary significantly across studied countries. We find five main factors impacting adoption: (1) political prioritization of lung cancer (2) financial incentives/cost sharing and hidden ancillary costs (3) infrastructure to support provision of screening services (4) awareness around lung cancer screening and risk factors and (5) cultural views and stigma around lung cancer. Although these factors have application across the countries, the weighting of each factor on driving or hindering adoption varies by country. The five areas set out by this research should be factored into policy making and implementation to maximize effectiveness and outreach of lung cancer screening programs.
Collapse
Affiliation(s)
| | - Tim Wilsdon
- Charles River Associates, London, United Kingdom
| | - Iqra Sarwar
- Charles River Associates, London, United Kingdom
| | | | - Megan Yuan
- Merck & Co., Inc., Kenilworth, NJ, United States
| |
Collapse
|
6
|
Leopold KT, Carter-Bawa L. Barriers to Lung Cancer Screening Access from the Perspective of the Patient and Current Interventions. Thorac Surg Clin 2023; 33:343-351. [PMID: 37806737 DOI: 10.1016/j.thorsurg.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
In the context of the Conceptual Model for Lung Cancer Screening Participation, this article describes patient barriers to lung cancer screening highlighting current interventions. Patient barriers include cognitive factors (lack of awareness, limited information/misinformation, and low perceived risk), factors related to access (logistical issues, no provider recommendation, cost, and other financial/social factors), and psychological factors (fear, fatalism, lung cancer worry, and stigma). Current interventions include the use of educational materials/presentations to address cognitive barriers, use of direct outreach and structural change to address factors related to access, and use of educational material focused on psychological barriers to address psychological barriers.
Collapse
Affiliation(s)
- Katherine T Leopold
- Hackensack University School of Medicine, 123 Metro Boulevard, Nutley, NJ 07110, USA
| | - Lisa Carter-Bawa
- Cancer Prevention Precision Control Institute, Center for Discovery & Innovation, at Hackensack Meridian Health, 111 Ideation Way, B430, Nutley, NJ 07110, USA.
| |
Collapse
|
7
|
Hall JM, Mkuu RS, Cho HD, Woodard JN, Kaye FJ, Bian J, Shenkman EA, Guo Y. Disparities Contributing to Late-Stage Diagnosis of Lung, Colorectal, Breast, and Cervical Cancers: Rural and Urban Poverty in Florida. Cancers (Basel) 2023; 15:5226. [PMID: 37958400 PMCID: PMC10647213 DOI: 10.3390/cancers15215226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/18/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Despite advances in cancer screening, late-stage cancer diagnosis is still a major cause of morbidity and mortality in the United States. In this study, we aim to understand demographic and geographic factors associated with receiving a late-stage diagnosis (LSD) of lung, colorectal, breast, or cervical cancer. (1) Methods: We analyzed data of patients with a cancer diagnosis between 2016 and 2020 from the Florida Cancer Data System (FCDS), a statewide population-based registry. To investigate correlates of LSD, we estimated multi-variable logistic regression models for each cancer while controlling for age, sex, race, insurance, and census tract rurality and poverty. (2) Results: Patients from high-poverty rural areas had higher odds for LSD of lung (OR = 1.23, 95% CI (1.10, 1.37)) and breast cancer (OR = 1.31, 95% CI (1.17,1.47)) than patients from low-poverty urban areas. Patients in high-poverty urban areas saw higher odds of LSD for lung (OR = 1.05 95% CI (1.00, 1.09)), breast (OR = 1.10, 95% CI (1.06, 1.14)), and cervical cancer (OR = 1.19, 95% CI (1.03, 1.37)). (3) Conclusions: Financial barriers contributing to decreased access to care likely drive LSD for cancer in rural and urban communities of Florida.
Collapse
Affiliation(s)
- Jaclyn M. Hall
- Department of Health Outcomes and Biomedical Informatics, University of Florida, 2199 Mowry Road, Gainesville, FL 32611, USA; (R.S.M.); (H.D.C.); (J.N.W.); (J.B.); (E.A.S.); (Y.G.)
- Cancer Informatics Shared Resource, University of Florida Health Cancer Center, 2033 Mowry Road, Gainesville, FL 32610, USA
| | - Rahma S. Mkuu
- Department of Health Outcomes and Biomedical Informatics, University of Florida, 2199 Mowry Road, Gainesville, FL 32611, USA; (R.S.M.); (H.D.C.); (J.N.W.); (J.B.); (E.A.S.); (Y.G.)
| | - Hee Deok Cho
- Department of Health Outcomes and Biomedical Informatics, University of Florida, 2199 Mowry Road, Gainesville, FL 32611, USA; (R.S.M.); (H.D.C.); (J.N.W.); (J.B.); (E.A.S.); (Y.G.)
- Cancer Informatics Shared Resource, University of Florida Health Cancer Center, 2033 Mowry Road, Gainesville, FL 32610, USA
| | - Jennifer N. Woodard
- Department of Health Outcomes and Biomedical Informatics, University of Florida, 2199 Mowry Road, Gainesville, FL 32611, USA; (R.S.M.); (H.D.C.); (J.N.W.); (J.B.); (E.A.S.); (Y.G.)
- Community Outreach and Engagement, University of Florida Health Cancer Center, 2033 Mowry Road, Gainesville, FL 32610, USA
| | - Frederic J. Kaye
- Division of Hematology and Oncology, Department of Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610, USA;
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, University of Florida, 2199 Mowry Road, Gainesville, FL 32611, USA; (R.S.M.); (H.D.C.); (J.N.W.); (J.B.); (E.A.S.); (Y.G.)
- Cancer Informatics Shared Resource, University of Florida Health Cancer Center, 2033 Mowry Road, Gainesville, FL 32610, USA
| | - Elizabeth A. Shenkman
- Department of Health Outcomes and Biomedical Informatics, University of Florida, 2199 Mowry Road, Gainesville, FL 32611, USA; (R.S.M.); (H.D.C.); (J.N.W.); (J.B.); (E.A.S.); (Y.G.)
| | - Yi Guo
- Department of Health Outcomes and Biomedical Informatics, University of Florida, 2199 Mowry Road, Gainesville, FL 32611, USA; (R.S.M.); (H.D.C.); (J.N.W.); (J.B.); (E.A.S.); (Y.G.)
- Cancer Informatics Shared Resource, University of Florida Health Cancer Center, 2033 Mowry Road, Gainesville, FL 32610, USA
| |
Collapse
|
8
|
Vachani A, Caruso C. Impact of low-dose computed tomography screening on lung cancer incidence and outcomes. Curr Opin Pulm Med 2023; 29:232-238. [PMID: 37191171 PMCID: PMC10247528 DOI: 10.1097/mcp.0000000000000974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
PURPOSE OF REVIEW To review findings from clinical trials of lung cancer screening (LCS), assess contemporary issues with implementation in clinical practice, and review emerging strategies to increase the uptake and efficiency of LCS. RECENT FINDINGS In 2013, the USPSTF recommended annual screening for individuals aged 55-80 years and currently smoke or quit within the past 15 years based on reduced mortality from lung cancer with annual low-dose computed tomography (LDCT) screening in the National Lung Screening Trial. Subsequent trials have demonstrated similar mortality outcomes in individuals with lower pack-year smoking histories. These findings, coupled with evidence for disparities in screening eligibility by race, resulted in updated guidelines by USPSTF to broaden eligibility criteria for screening. Despite this body of evidence, implementation in the United States has been suboptimal with fewer than 20% of eligible individuals receiving a screen. Barriers to efficient implementation are multifactorial and include patient, clinician, and system-level factors. SUMMARY Multiple randomized trials have established that annual LCS reduces mortality from lung cancer; however, several areas of uncertainty exist on the effectiveness of annual LDCT. Ongoing research is examining approaches to improve the uptake and efficiency of LCS, such as the use of risk-prediction models and biomarkers for identification of high-risk individuals.
Collapse
Affiliation(s)
- Anil Vachani
- Pulmonary, Allergy, and Critical Care Division, University of Pennsylvania Perelman School of Medicine
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
| | - Christopher Caruso
- Pulmonary, Allergy, and Critical Care Division, University of Pennsylvania Perelman School of Medicine
| |
Collapse
|
9
|
Catarata MJ, Van Geffen WH, Banka R, Ferraz B, Sidhu C, Carew A, Viola L, Gijtenbeek R, Hardavella G. ERS International Congress 2022: highlights from the Thoracic Oncology Assembly. ERJ Open Res 2023; 9:00579-2022. [PMID: 37583965 PMCID: PMC10423989 DOI: 10.1183/23120541.00579-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 05/31/2023] [Indexed: 08/17/2023] Open
Abstract
Thoracic malignancies are associated with a substantial public health burden. Lung cancer is the leading cause of cancer-related mortality worldwide, with significant impact on patients' quality of life. Following 2 years of virtual European Respiratory Society (ERS) Congresses due to the COVID-19 pandemic, the 2022 hybrid ERS Congress in Barcelona, Spain allowed peers from all over the world to meet again and present their work. Thoracic oncology experts presented best practices and latest developments in lung cancer screening, lung cancer diagnosis and management. Early lung cancer diagnosis, subsequent pros and cons of aggressive management, identification and management of systemic treatments' side-effects, and the application of artificial intelligence and biomarkers across all aspects of the thoracic oncology pathway were among the areas that triggered specific interest and will be summarised here.
Collapse
Affiliation(s)
- Maria Joana Catarata
- Pulmonology Department, Hospital de Braga, Braga, Portugal
- Tumour & Microenvironment Interactions Group, I3S-Institute for Health Research & Innovation, University of Porto, Porto, Portugal
| | - Wouter H. Van Geffen
- Department of Respiratory Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - Radhika Banka
- P.D. Hinduja National Hospital and Medical Research Centre, Mumbai, India
| | - Beatriz Ferraz
- Pulmonology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal
- ICBAS School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | | | - Alan Carew
- Queensland Lung Transplant Service, Department of Thoracic Medicine, Prince Charles Hospital, Brisbane, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Lucia Viola
- Thoracic Oncology Service, Fundación Neumológica Colombiana, Bogotá, Colombia
- Thoracic Clinic, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (Fundación CTIC), Bogotá, Colombia
| | - Rolof Gijtenbeek
- Department of Respiratory Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - Georgia Hardavella
- 9th Department of Respiratory Medicine, “Sotiria” Athens Chest Diseases Hospital, Athens, Greece
| |
Collapse
|
10
|
Passek K, Ronellenfitsch U, Meisenbacher K, Peters A, Böckler D. [Results of a single center vascular screening program in Germany]. CHIRURGIE (HEIDELBERG, GERMANY) 2023; 94:342-348. [PMID: 36808496 PMCID: PMC10042912 DOI: 10.1007/s00104-023-01821-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 01/16/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Cardiovascular diseases are the main cause of death in Europe with a relevant socioeconomic burden. A screening program for vascular diseases in asymptomatic persons with a defined risk constellation can lead to an early diagnosis. OBJECTIVE The study examined a screening program for carotid stenosis, peripheral arterial occlusive disease (PAOD) and abdominal aortic aneurysms (AAA) in persons without any known vascular disease with respect to demographic data, risk factors, pre-existing conditions, medication intake, detection of pathological findings and/or findings requiring treatment. MATERIAL AND METHODS Test subjects were invited using various information material and filled in a questionnaire on cardiovascular risk factors. The screening took place with measurement of the ABI and duplex sonography as a monocentric prospective single arm study within 1 year. Endpoints were the prevalence of risk factors and pathological and/or results requiring treatment. RESULTS A total of 391 persons participated, 36% presented with at least 1 cardiovascular risk factor, 35.5% with 2 and 14.4% with 3 or more. The sonography showed results requiring control with a carotid stenosis of < 50-> 75% or occlusion in 9%. An AAA with a diameter of 3.0-4.5 cm was diagnosed in 0.9% and a pathological ABI < 0.9 or > 1.3 in 12.3%. The indications for a pharmacotherapy were found in 17% and no operation was recommended. CONCLUSION The practicability of a screening program for carotid stenosis, PAOD and AAA of a defined risk population was shown. Vascular pathologies that required treatment were hardly found in the catchment area of the hospital. Consequently, the implementation of this screening program in Germany based on the collected data cannot currently be recommended in this form.
Collapse
Affiliation(s)
- K Passek
- Klinik für Gefäßchirurgie und Endovaskuläre Chirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Deutschland.
| | - U Ronellenfitsch
- Klinik für viszerale, Gefäß- und endokrine Chirurgie, Universitätsklinikum Halle (Saale), Ernst-Grube-Straße 40, 06120, Halle, Deutschland
| | | | | | | |
Collapse
|