Patient-Reported Barriers and Preferred Interventions to Improve Lung Cancer Screening Uptake

IF 4 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Journal of the American College of Radiology Pub Date : 2025-03-01 DOI:10.1016/j.jacr.2024.10.010
Jinho Jung BS , Eisa Razzak BA , Axs Roc Avenido BS , Ali Rashidi MD , Stephanie Jia BS , Natalie Q. Tran BS , Rachel Yao BS , Emily L. Nguyen BS , Arsanyous Bernaba BS , Richard Echeverria MSc , Tan Q. Nguyen MD , Amir Imanzadeh MD , Gelareh Sadigh MD
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Abstract

Objective

Lung cancer screening (LCS) utilization remains low. We aimed at assessing LCS patient-reported barriers and preferred interventions to improve uptake.

Methods

Between July and November 2023, an electronic 60-item survey was completed by consented patients aged 50 to 80 years who were due to receive LCS, and their eligibility for LCS was confirmed. The survey assessed patients’ LCS perceptions and preferences to increase uptake. Regression analyses was performed to assess associated sociodemographic factors.

Results

In all, 12,558 patients were contacted; 1,396 responded, 871 were interested, and 86 were eligible and enrolled (mean age: 62.4; 40% female; 79.1% White, 4.7% Asian, 2.3% Black). LCS was perceived as beneficial for early lung cancer detection by 91.9%, yet only 24.4% had undergone LCS previously. Of the respondents, 54.7% identified barriers to LCS with the most common being cost (23.3%) and lack of symptoms (23.3%). Current (versus former) smokers reported higher barrier scores (B coefficient: 7.06, 95% confidence interval [CI], 1.71-13.12) and lower self-efficacy scores (B coefficient: −5.15; 95% CI, −8.73 to −1.56). Patients with prior cancer screening had higher self-efficacy scores (B coefficient, 8.92; 95% CI, 1.95-15.88). Preferred interventions included patient reminders (63.3%), primary care provider notification about LCS eligibility (62.0%), and educational materials (60.8%). Patients with higher self-efficacy (odds ratio, 1.16; 95% CI, 1.06-1.27) were more likely to prefer reminders. Patients with personal cancer history were more likely to prefer primary care provider notification (odds ratio, 5.81; 95% CI, 1.15,29.22).

Conclusions

Our results underscore the LCS perceived benefits and barriers, as well as patient-preferred interventions to enhance screening participation.
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患者反映的障碍和改善肺癌筛查接受率的首选干预措施
目标肺癌筛查(LCS)的利用率仍然很低。我们旨在评估肺癌筛查患者报告的障碍和首选干预措施,以提高肺癌筛查的利用率。方法在 2023 年 7 月至 11 月期间,对年龄在 50 岁至 80 岁之间、同意接受肺癌筛查并确认符合肺癌筛查条件的患者进行了一项 60 个项目的电子调查。该调查评估了患者对 LCS 的看法和偏好,以提高使用率。结果共联系了 12,558 名患者;1,396 人回复,871 人感兴趣,86 人符合条件并注册(平均年龄:62.4 岁;40% 为女性;79.1% 为白人,4.7% 为亚洲人,2.3% 为黑人)。91.9%的受访者认为 LCS 有利于早期肺癌检测,但只有 24.4% 的受访者以前接受过 LCS。54.7%的受访者指出了进行 LCS 的障碍,其中最常见的障碍是费用(23.3%)和缺乏症状(23.3%)。目前(相对于曾经)吸烟者的障碍得分更高(B 系数:7.06,95% 置信区间 [CI],1.71-13.12),自我效能得分更低(B 系数:-5.15;95% 置信区间,-8.73 至-1.56)。曾接受过癌症筛查的患者自我效能得分更高(B系数:8.92;95% CI:1.95-15.88)。首选干预措施包括患者提醒(63.3%)、初级保健提供者关于 LCS 资格的通知(62.0%)和教育材料(60.8%)。自我效能感较高的患者(几率比,1.16;95% CI,1.06-1.27)更倾向于提醒。有个人癌症病史的患者更倾向于由初级保健提供者发出通知(几率比为 5.81;95% CI 为 1.15-29.22)。
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来源期刊
Journal of the American College of Radiology
Journal of the American College of Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
6.30
自引率
8.90%
发文量
312
审稿时长
34 days
期刊介绍: The official journal of the American College of Radiology, JACR informs its readers of timely, pertinent, and important topics affecting the practice of diagnostic radiologists, interventional radiologists, medical physicists, and radiation oncologists. In so doing, JACR improves their practices and helps optimize their role in the health care system. By providing a forum for informative, well-written articles on health policy, clinical practice, practice management, data science, and education, JACR engages readers in a dialogue that ultimately benefits patient care.
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