Pub Date : 2024-09-01DOI: 10.1016/j.jacr.2024.04.013
{"title":"Patient-Friendly Summary of the ACR Appropriateness Criteria®: Thoracoabdominal Aortic Aneurysm or Dissection: Treatment Planning and Follow-Up","authors":"","doi":"10.1016/j.jacr.2024.04.013","DOIUrl":"10.1016/j.jacr.2024.04.013","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1546144024004265/pdfft?md5=78dba52c2d6ad1f8788102f1bbc1783f&pid=1-s2.0-S1546144024004265-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140893050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jacr.2024.06.008
By targeting income and financial stress as key social determinants of health, unconditional cash transfers (UCTs) may improve cancer health outcomes and reduce cancer health disparities. Described in policy circles as guaranteed or basic income, UCTs have been shown to improve a range of health outcomes in low-income populations but have not yet been examined as a targeted intervention for people with cancer. This article describes some of the lessons learned from launching the Guaranteed Income and Financial Treatment trial, a two-arm randomized controlled trial of UCTs in oncology, along with a rationale for studying UCTs in people with cancer who have low incomes, and presents an introductory primer on UCT research for oncology clinicians and researchers and future directions for research.
{"title":"Studying Guaranteed Income in Oncology: Lessons Learned From Launching the Guaranteed Income and Financial Treatment Trial","authors":"","doi":"10.1016/j.jacr.2024.06.008","DOIUrl":"10.1016/j.jacr.2024.06.008","url":null,"abstract":"<div><p>By targeting income and financial stress as key social determinants of health, unconditional cash transfers (UCTs) may improve cancer health outcomes and reduce cancer health disparities. Described in policy circles as guaranteed or basic income, UCTs have been shown to improve a range of health outcomes in low-income populations but have not yet been examined as a targeted intervention for people with cancer. This article describes some of the lessons learned from launching the Guaranteed Income and Financial Treatment trial, a two-arm randomized controlled trial of UCTs in oncology, along with a rationale for studying UCTs in people with cancer who have low incomes, and presents an introductory primer on UCT research for oncology clinicians and researchers and future directions for research.</p></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1546144024005325/pdfft?md5=56697ed80948ba1bf3ef85c2958dbdb2&pid=1-s2.0-S1546144024005325-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141441208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jacr.2024.07.001
Introduction
Financial toxicity is common among patients with cancer, as are co-occurring health-related social risks (HRSRs). There is limited evidence to support best practices in screening for HRSRs and financial toxicity in the cancer context. This analysis sought to understand variations of identified needs based on treatment course using data from a large screening program.
Methods
This 2022 to 2023 screening quality improvement program included four services (breast, gastrointestinal, gynecologic, thoracic) at an urban comprehensive cancer center. The Comprehensive Score for Financial Toxicity measured financial toxicity. Patients completed an HRSR checklist documenting food, housing, medication, or transportation insecurity and financial borrowing practices. Differences were evaluated by treatment course (radiation therapy [RT] versus other treatment and RT plus chemotherapy versus other treatment).
Results
Screening surveys were sent to 70,983 unique patients; 38,249 completed a screening survey (54% response rate). Of responders, 4% (n = 1,686) underwent RT in the 120 days before their survey, and 3% (n = 1,033) received RT in combination with chemotherapy. Overall, patients receiving RT had lower unadjusted Comprehensive Score for Financial Toxicity scores, indicating worse financial toxicity. The proportion of patients receiving RT reporting unmet transportation (15% versus 12%, P < .001) and food (13% versus 11%, P = .02) needs was significantly higher than for patients not receiving RT. More patients receiving RT borrowed money than did patients not receiving RT (17% versus 15%, P = .02). In multivariable models, RT (alone or in combination) was associated with worse financial toxicity and transportation difficulties.
Conclusions
Screening for financial toxicity and HRSR is possible at a large cancer center. Patients receiving RT have higher transportation insecurity and worse financial toxicity compared with those receiving other treatments. Tailored intervention throughout the treatment trajectory is essential.
{"title":"Screening for Health-Related Social Needs and Financial Toxicity Among Patients With Cancer Treated With Radiation Therapy: Findings From a Quality Improvement Project","authors":"","doi":"10.1016/j.jacr.2024.07.001","DOIUrl":"10.1016/j.jacr.2024.07.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Financial toxicity is common among patients with cancer, as are co-occurring health-related social risks (HRSRs). There is limited evidence to support best practices in screening for HRSRs and financial toxicity in the cancer context. This analysis sought to understand variations of identified needs based on treatment course using data from a large screening program.</p></div><div><h3>Methods</h3><p>This 2022 to 2023 screening quality improvement program included four services (breast, gastrointestinal, gynecologic, thoracic) at an urban comprehensive cancer center. The Comprehensive Score for Financial Toxicity measured financial toxicity. Patients completed an HRSR checklist documenting food, housing, medication, or transportation insecurity and financial borrowing practices. Differences were evaluated by treatment course (radiation therapy [RT] versus other treatment and RT plus chemotherapy versus other treatment).</p></div><div><h3>Results</h3><p>Screening surveys were sent to 70,983 unique patients; 38,249 completed a screening survey (54% response rate). Of responders, 4% (n = 1,686) underwent RT in the 120 days before their survey, and 3% (n = 1,033) received RT in combination with chemotherapy. Overall, patients receiving RT had lower unadjusted Comprehensive Score for Financial Toxicity scores, indicating worse financial toxicity. The proportion of patients receiving RT reporting unmet transportation (15% versus 12%, <em>P</em> < .001) and food (13% versus 11%, <em>P</em> = .02) needs was significantly higher than for patients not receiving RT. More patients receiving RT borrowed money than did patients not receiving RT (17% versus 15%, <em>P</em> = .02). In multivariable models, RT (alone or in combination) was associated with worse financial toxicity and transportation difficulties.</p></div><div><h3>Conclusions</h3><p>Screening for financial toxicity and HRSR is possible at a large cancer center. Patients receiving RT have higher transportation insecurity and worse financial toxicity compared with those receiving other treatments. Tailored intervention throughout the treatment trajectory is essential.</p></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1546144024005982/pdfft?md5=834972c6bf0738f388fdde8c96e0b756&pid=1-s2.0-S1546144024005982-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141545628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jacr.2023.11.029
Purpose
Osteoporotic vertebral compression fractures (OVCFs) are a highly prevalent source of morbidity and mortality, and preventive treatment has been demonstrated to be both effective and cost effective. To take advantage of the information available on existing chest and abdominal radiographs, the authors’ study group has developed software to access these radiographs for OVCFs with high sensitivity and specificity using an established artificial intelligence deep learning algorithm. The aim of this analysis was to assess the potential cost-effectiveness of implementing this software.
Methods
A deterministic expected-value cost-utility model was created, combining a tree model and a Markov model, to compare the strategies of opportunistic screening for OVCFs against usual care. Total costs and total quality-adjusted life-years were calculated for each strategy. Screening and treatment costs were considered from a limited societal perspective, at 2022 prices.
Results
In the base case, assuming a cost of software implantation of $10 per patient screened, the screening strategy dominated the nonscreening strategy: it resulted in lower cost and increased quality-adjusted life-years. The lower cost was due primarily to the decreased costs associated with fracture treatment and decreased probability of requiring long-term care in patients who received preventive treatment. The screening strategy was dominant up to a cost of $46 per patient screened.
Conclusions
Artificial intelligence–based opportunistic screening for OVCFs on existing radiographs can be cost effective from a societal perspective.
{"title":"Cost-Effectiveness of Artificial Intelligence–Based Opportunistic Compression Fracture Screening of Existing Radiographs","authors":"","doi":"10.1016/j.jacr.2023.11.029","DOIUrl":"10.1016/j.jacr.2023.11.029","url":null,"abstract":"<div><h3>Purpose</h3><p>Osteoporotic vertebral compression fractures (OVCFs) are a highly prevalent source of morbidity and mortality, and preventive treatment has been demonstrated to be both effective and cost effective. To take advantage of the information available on existing chest and abdominal radiographs, the authors’ study group has developed software to access these radiographs for OVCFs with high sensitivity and specificity using an established artificial intelligence deep learning algorithm. The aim of this analysis was to assess the potential cost-effectiveness of implementing this software.</p></div><div><h3>Methods</h3><p>A deterministic expected-value cost-utility model was created, combining a tree model and a Markov model, to compare the strategies of opportunistic screening for OVCFs against usual care. Total costs and total quality-adjusted life-years were calculated for each strategy. Screening and treatment costs were considered from a limited societal perspective, at 2022 prices.</p></div><div><h3>Results</h3><p><span>In the base case, assuming a cost of software implantation of $10 per patient screened, the screening strategy dominated the nonscreening strategy: it resulted in lower cost and increased quality-adjusted life-years. The lower cost was due primarily to the decreased costs associated with </span>fracture treatment and decreased probability of requiring long-term care in patients who received preventive treatment. The screening strategy was dominant up to a cost of $46 per patient screened.</p></div><div><h3>Conclusions</h3><p>Artificial intelligence–based opportunistic screening for OVCFs on existing radiographs can be cost effective from a societal perspective.</p></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jacr.2024.03.012
{"title":"Let’s Talk About Low-Dose Contrast Medium as an Option to Lower Carbon Footprint","authors":"","doi":"10.1016/j.jacr.2024.03.012","DOIUrl":"10.1016/j.jacr.2024.03.012","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1546144024003004/pdfft?md5=2a8f831e2ac01a03ebaecc12517152ed&pid=1-s2.0-S1546144024003004-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jacr.2024.02.032
Objective
To determine the incidence, timing, and long-term outcomes of unilateral axillary lymphadenopathy ipsilateral to vaccine site (UIAL) on screening mammography after COVID-19 vaccination.
Methods
This retrospective, multisite study included consecutive patients undergoing screening mammography February 8, 2021, to January 31, 2022, with at least 1 year of follow-up. UIAL was typically considered benign (BI-RADS 1 or 2) in the setting of recent (≤6 weeks) vaccination or BI-RADS 0 (ultrasound recommended) when accompanied by a breast finding or identified >6 weeks postvaccination. Vaccination status and manufacturer were obtained from regional registries. Lymphadenopathy rates in vaccinated patients with and without UIAL were compared using Pearson’s χ2 test.
Results
There were 44,473 female patients (mean age 60.4 ± 11.4 years) who underwent screening mammography at five sites, and 40,029 (90.0%) received at least one vaccine dose. Ninety-four (0.2%) presented with UIAL, 1 to 191 days postvaccination (median 13.5 [interquartile range: 5.0-31.0]). Incidence declined from 2.1% to 0.9% to ≤0.5% after 1, 2, and 3 weeks and persisted up to 36 weeks (P < .001). UIAL did not vary across manufacturer (P = .15). Of 94, 77 (81.9%) were BI-RADS 1 or 2 at screening. None were diagnosed with malignancy at 1-year follow-up. Seventeen (18.1%) were BI-RADS 0 at screening. At diagnostic workup, 13 (76.5%) were BI-RADS 1 or 2, 2 (11.8%) were BI-RADS 3, and 2 (11.8%) were BI-RADS 4. Both BI-RADS 4 patients had malignant status and ipsilateral breast malignancies. Of BI-RADS 3 patients, at follow-up, one was biopsied yielding benign etiology, and one was downgraded to BI-RADS 2.
Discussion
Isolated UIAL on screening mammography performed within 6 months of COVID-19 vaccination can be safely assessed as benign.
{"title":"Incidence, Timing, and Long-Term Outcomes of COVID-19 Vaccine-Related Lymphadenopathy on Screening Mammography","authors":"","doi":"10.1016/j.jacr.2024.02.032","DOIUrl":"10.1016/j.jacr.2024.02.032","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the incidence, timing, and long-term outcomes of unilateral axillary lymphadenopathy ipsilateral to vaccine site (UIAL) on screening mammography after COVID-19 vaccination.</p></div><div><h3>Methods</h3><p>This retrospective, multisite study included consecutive patients undergoing screening mammography February 8, 2021, to January 31, 2022, with at least 1 year of follow-up. UIAL was typically considered benign (BI-RADS 1 or 2) in the setting of recent (≤6 weeks) vaccination or BI-RADS 0 (ultrasound recommended) when accompanied by a breast finding or identified >6 weeks postvaccination. Vaccination status and manufacturer were obtained from regional registries. Lymphadenopathy rates in vaccinated patients with and without UIAL were compared using Pearson’s χ<sup>2</sup> test.</p></div><div><h3>Results</h3><p>There were 44,473 female patients (mean age 60.4 ± 11.4 years) who underwent screening mammography at five sites, and 40,029 (90.0%) received at least one vaccine dose. Ninety-four (0.2%) presented with UIAL, 1 to 191 days postvaccination (median 13.5 [interquartile range: 5.0-31.0]). Incidence declined from 2.1% to 0.9% to ≤0.5% after 1, 2, and 3 weeks and persisted up to 36 weeks (<em>P</em> < .001). UIAL did not vary across manufacturer (<em>P</em> = .15)<em>.</em> Of 94, 77 (81.9%) were BI-RADS 1 or 2 at screening. None were diagnosed with malignancy at 1-year follow-up. Seventeen (18.1%) were BI-RADS 0 at screening. At diagnostic workup, 13 (76.5%) were BI-RADS 1 or 2, 2 (11.8%) were BI-RADS 3, and 2 (11.8%) were BI-RADS 4. Both BI-RADS 4 patients had malignant status and ipsilateral breast malignancies. Of BI-RADS 3 patients, at follow-up, one was biopsied yielding benign etiology, and one was downgraded to BI-RADS 2.</p></div><div><h3>Discussion</h3><p>Isolated UIAL on screening mammography performed within 6 months of COVID-19 vaccination can be safely assessed as benign.</p></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S154614402400276X/pdfft?md5=956782ac48d7fc738b21f7bb44f7f772&pid=1-s2.0-S154614402400276X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140095301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jacr.2024.03.007
Purpose
The aim of this study was to evaluate the effectiveness of management strategies for blunt splenic injuries in adult patients.
Methods
Patients 18 years and older with blunt splenic injuries registered via the Trauma Quality Improvement Program (2013-2019) were identified. Management strategies initiated within 24 hours of hospital presentation were classified as watchful waiting, embolization, surgery, or combination therapy. Patients were stratified by injury grade. Linear models estimated each strategy’s effect on hospital length of stay (LOS), intensive care unit (ICU) LOS, and mortality.
Results
Of 81,033 included patients, 86.3%, 10.9%, 2.5%, and 0.3% of patients received watchful waiting, surgery, embolization, and combination therapy, respectively. Among patients with low-grade injuries and compared with surgery, embolization was associated with shorter hospital LOS (9.4 days, Q < .001, Cohen’s d = .30) and ICU LOS (5.0 days, Q < .001, Cohen’s d = .44). Among patients with high-grade injuries and compared with surgery, embolization was associated with shorter hospital LOS (8.7 days, Q < .001, Cohen’s d = .12) and ICU LOS (4.5 days, Q < .001, Cohen’s d = .23). Among patients with low- and high-grade injuries, the odds ratios for in-hospital mortality associated with surgery compared with embolization were 4.02 (Q < .001) and 4.38 (Q < .001), respectively.
Conclusions
Among patients presenting with blunt splenic injuries and compared with surgery, embolization was associated with shorter hospital LOS, shorter ICU LOS, and lower risk for mortality.
目的:评估成年患者钝性脾损伤处理策略的有效性:通过创伤质量改进计划(2013-19 年)登记的 18 岁及以上钝性脾损伤患者。入院 24 小时内启动的治疗策略分为观察等待(WW)、栓塞、手术或综合治疗。患者按损伤等级进行分层。线性模型估算了每种策略对住院时间(LOS)、重症监护室(ICU)住院时间和死亡率的影响:在纳入的81033名患者中,分别有86.3%、10.9%、2.5%和0.3%的患者接受了WW、手术、栓塞和综合治疗。在低级别损伤患者中,与手术相比,栓塞治疗缩短了住院时间(9.4天,Q < .001,Cohen's d = .30)和重症监护室住院时间(5.0天,Q < .001,Cohen's d = .44)。在高级别损伤患者中,与手术相比,栓塞治疗缩短了住院时间(8.7 天,Q < .001,Cohen's d = .12)和重症监护室住院时间(4.5 天,Q < .001,Cohen's d = .23)。在低度和高度损伤患者中,与栓塞相比,手术的院内死亡率几率比分别为4.02(Q < .001)和4.38(Q < .001):结论:在钝性脾损伤患者中,与手术相比,栓塞治疗的住院时间更短、重症监护室住院时间更短、死亡风险更低。
{"title":"Contemporary Management of Blunt Splenic Trauma in Adults: An Analysis of the Trauma Quality Improvement Program Registry","authors":"","doi":"10.1016/j.jacr.2024.03.007","DOIUrl":"10.1016/j.jacr.2024.03.007","url":null,"abstract":"<div><h3>Purpose</h3><p>The aim of this study was to evaluate the effectiveness of management strategies for blunt splenic injuries in adult patients.</p></div><div><h3>Methods</h3><p>Patients 18 years and older with blunt splenic injuries registered via the Trauma Quality Improvement Program (2013-2019) were identified. Management strategies initiated within 24 hours of hospital presentation were classified as watchful waiting, embolization<span>, surgery, or combination therapy. Patients were stratified by injury grade. Linear models estimated each strategy’s effect on hospital length of stay (LOS), intensive care unit (ICU) LOS, and mortality.</span></p></div><div><h3>Results</h3><p>Of 81,033 included patients, 86.3%, 10.9%, 2.5%, and 0.3% of patients received watchful waiting, surgery, embolization, and combination therapy, respectively. Among patients with low-grade injuries and compared with surgery, embolization was associated with shorter hospital LOS (9.4 days, <em>Q</em> < .001, Cohen’s <em>d</em> = .30) and ICU LOS (5.0 days, <em>Q</em> < .001, Cohen’s <em>d</em> = .44). Among patients with high-grade injuries and compared with surgery, embolization was associated with shorter hospital LOS (8.7 days, <em>Q</em> < .001, Cohen’s <em>d</em> = .12) and ICU LOS (4.5 days, <em>Q</em> < .001, Cohen’s <em>d</em> = .23). Among patients with low- and high-grade injuries, the odds ratios for in-hospital mortality associated with surgery compared with embolization were 4.02 (<em>Q</em> < .001) and 4.38 (<em>Q</em> < .001), respectively.</p></div><div><h3>Conclusions</h3><p>Among patients presenting with blunt splenic injuries and compared with surgery, embolization was associated with shorter hospital LOS, shorter ICU LOS, and lower risk for mortality.</p></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jacr.2024.04.022
{"title":"Patient-Friendly Summary of the ACR Appropriateness Criteria®: Diffuse Lung Disease","authors":"","doi":"10.1016/j.jacr.2024.04.022","DOIUrl":"10.1016/j.jacr.2024.04.022","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1546144024004356/pdfft?md5=b5ae0e1d2537c80e3a1253cebf633c2a&pid=1-s2.0-S1546144024004356-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jacr.2024.05.005
Objective
There are limited data about food insecurity within the cancer screening setting. To inform the potential need for food insecurity interventions, our study evaluated the association between food security and mammographic screening among eligible participants.
Methods
Female respondents aged 40 to 74 years in the 2019 National Health Interview Survey without history of breast cancer were included. Food insecurity was assessed using the Six-Item Food Security Scale developed by the National Center for Health Statistics. The proportion of patients who reported mammographic screening within the last year was estimated, stratified by food security. Multiple variable logistic regression analyses evaluated the association between food security and mammography screening, adjusted for potential confounders. All analyses were performed accounting for complex survey design features.
Results
In all, 8,956 weighted survey respondents met inclusion criteria; 90.1% were classified as having high or marginal food security, of whom 56.6% reported screening; 6.1% were classified with low food security, of whom 42.1% reported screening; and 3.8% were classified with very low food security, of whom 43.1% reported screening. In our unadjusted analyses, participants with low food security (P < .001) and very low food security (P < .001) were less likely to report screening within the last year. In our adjusted analyses, participants with food insecurity (P = .009) were less likely to report screening.
Discussion
In a nationally representative cross-sectional survey, participants with food insecurity were less likely to report mammography screening. Radiology practices should consider screening patients for food insecurity and social determinants of health. Evidence-based food insecurity interventions may increase adherence to mammography screening.
目的:有关癌症筛查中食物不安全问题的数据十分有限。为了了解对食物不安全干预措施的潜在需求,我们的研究评估了符合条件的参与者中食物安全与乳房X光筛查之间的关联:方法:纳入 2019 年全国健康访谈调查中 40-74 岁无乳腺癌病史的女性受访者。采用美国国家卫生统计中心开发的六项目食品安全量表评估食品不安全状况。根据食品安全状况进行分层,估算出报告在过去一年中进行过乳腺 X 线照相筛查的患者比例。多变量逻辑回归分析评估了食品安全与乳腺放射摄影筛查之间的关系,并对潜在的混杂因素进行了调整。所有分析均考虑了复杂的调查设计特点:8956名加权调查对象符合纳入标准。90.1%的受访者被归类为食品安全程度高或边缘化,其中56.6%的受访者报告进行了筛查。6.1%的受访者被归类为低粮食安全水平,其中 42.1%的受访者报告进行了筛查。3.8%的人被归类为食品安全程度极低,其中 43.1%的人报告进行了筛查。在我们的未调整分析中,低食品安全参与者(pDiscussion:在一项具有全国代表性的横断面调查中,缺乏粮食安全的参与者较少报告进行乳腺放射摄影筛查。放射科应考虑对患者进行食物不安全和健康社会决定因素筛查。以证据为基础的食物不安全干预措施可提高乳腺放射摄影筛查的依从性。
{"title":"The Association Between Food Security and Mammography Screening: Cross-Sectional Survey Results From the National Health Interview Survey","authors":"","doi":"10.1016/j.jacr.2024.05.005","DOIUrl":"10.1016/j.jacr.2024.05.005","url":null,"abstract":"<div><h3>Objective</h3><p>There are limited data about food insecurity within the cancer screening setting. To inform the potential need for food insecurity interventions, our study evaluated the association between food security and mammographic screening among eligible participants.</p></div><div><h3>Methods</h3><p>Female respondents aged 40 to 74 years in the 2019 National Health Interview Survey without history of breast cancer were included. Food insecurity was assessed using the Six-Item Food Security Scale developed by the National Center for Health Statistics. The proportion of patients who reported mammographic screening within the last year was estimated, stratified by food security. Multiple variable logistic regression analyses evaluated the association between food security and mammography screening, adjusted for potential confounders. All analyses were performed accounting for complex survey design features.</p></div><div><h3>Results</h3><p>In all, 8,956 weighted survey respondents met inclusion criteria; 90.1% were classified as having high or marginal food security, of whom 56.6% reported screening; 6.1% were classified with low food security, of whom 42.1% reported screening; and 3.8% were classified with very low food security, of whom 43.1% reported screening. In our unadjusted analyses, participants with low food security (<em>P</em> < .001) and very low food security (<em>P</em> < .001) were less likely to report screening within the last year. In our adjusted analyses, participants with food insecurity (<em>P</em> = .009) were less likely to report screening.</p></div><div><h3>Discussion</h3><p>In a nationally representative cross-sectional survey, participants with food insecurity were less likely to report mammography screening. Radiology practices should consider screening patients for food insecurity and social determinants of health. Evidence-based food insecurity interventions may increase adherence to mammography screening.</p></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1546144024005076/pdfft?md5=b5d4829fb7287c588bf8bf85c0a48f28&pid=1-s2.0-S1546144024005076-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jacr.2024.05.007
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