AJPM focus最新文献

{"title":"National Trends in Social Media Food Marketing Expenditures: 2020–2021","authors":"Marie A. Bragg PhD ,&nbsp;Stephanie L. Albert PhD ,&nbsp;Omni L. Cassidy PhD ,&nbsp;Lisa M. Powell PhD ,&nbsp;Pasquale E. Rummo PhD","doi":"10.1016/j.focus.2025.100440","DOIUrl":"10.1016/j.focus.2025.100440","url":null,"abstract":"<div><h3>Introduction</h3><div>This study leverages advertising industry data to quantify social media advertising expenditures and advertising impressions of the food and beverage industry on Facebook, Twitter/X, and Instagram from January 2019 to August 2021.</div></div><div><h3>Methods</h3><div>This is a cross-sectional analysis of Pathmatics data for Facebook (<em>n</em>=33 months), Twitter/X (<em>n</em>=29 months), and Instagram (<em>n</em>=18 months). Primary outcomes were monthly trends expenditures of food/beverage advertising and the number of views and expenditures of food/beverage advertising by platform (e.g., TV, online, mobile, print). Primary outcomes was measured by monthly expenditures by (1) social media company, (2) brand, and (3) before COVID-19 versus the first year of the pandemic.</div></div><div><h3>Results</h3><div>Between April 1, 2020, and August 31, 2021, adult social media users viewed approximately 335 billion food/beverage advertising on social media, including 94.4 billion food advertising on Facebook, 50.6 billion on Twitter/X, and 190.6 billion on Instagram. The 10 most advertised food/beverage brands spent approximately $833 million, $259 million, and $1.7 billion promoting advertising on Facebook, Twitter/X, and Instagram. Total impressions increased by 105%, and expenditures increased by 182% across all 3 platforms during this time period. Comparing pre– with post–COVID-19 periods on Facebook indicated a significant difference in trends in the number of impressions (<em>p</em> for interaction&lt;0.001) and total expenditures (<em>p</em> for interaction&lt;0.001).</div></div><div><h3>Conclusions</h3><div>These data reveal that the food/beverage industry spends at least $2.8 billion on social media advertising, which generate billions of views for their products online. Determining adults’ exposure to social media food advertising is critical for understanding the upstream factors that shape the risk for diet-related diseases.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"5 1","pages":"Article 100440"},"PeriodicalIF":0.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-Related Social Needs and Cervical Cancer Screening in Alliance Chicago Community Health Centers","authors":"Carla Salazar MPH, CPH ,&nbsp;Eve Walter PhD ,&nbsp;Ta-Yun Yang MS ,&nbsp;Mita Sanghavi Goel MD, MPH, FACP","doi":"10.1016/j.focus.2025.100439","DOIUrl":"10.1016/j.focus.2025.100439","url":null,"abstract":"<div><h3>Introduction</h3><div>This study explores the relationship between health-related social needs and cervical cancer screening among community health center patients.</div></div><div><h3>Methods</h3><div>The authors analyzed data from March 2020 to March 2023 for women aged 24–64 years seeking care at a community health center across 19 states that share an electronic data repository. Health-related social needs were assessed through (1) health-related social needs questionnaire, (2) health-related social needs questionnaire + keyword search for health-related social needs (expanded health-related social needs capture), and (3) a homelessness flag. The authors examined the completion of cervical cancer screening before and after health-related social need screenings in unadjusted and adjusted analyses.</div></div><div><h3>Results</h3><div>Most women identified as Hispanic/Latino, were aged between 31 and 64 years, were single, had Medicaid, and had an income &lt;100% federal poverty level. Food insecurity was the most common health-related social need, with a 13% prevalence. Before health-related social need screenings, 64% of the population completed cervical cancer screening. Women with health-related social needs had no significant differences in cervical cancer screening from those without; however, when stratified by age, women aged 24–30 years with health-related social needs reported higher cervical cancer screening rates than those without (71% vs 68%, <em>p</em>&lt;0.01), and women aged 31–64 years with health-related social needs had lower cervical cancer screening rates than those without (60% vs 62%, <em>p</em>&lt;0.01). After health-related social need screenings, the rates of cervical cancer screening were similar by health-related social need, regardless of age.</div></div><div><h3>Conclusions</h3><div>Our findings showed that health-related social needs were associated with cervical cancer screening, with differences varying by age group and type of social need. Women aged 24–30 years with food insecurity had significantly higher cervical cancer screening rates than those without health-related social needs, and women of any age with housing insecurity had significantly lower cervical cancer screening rates than those without health-related social needs. After health-related social need screenings, disparities persisted among women who had experiences of homelessness.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"5 1","pages":"Article 100439"},"PeriodicalIF":0.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diverging Patterns of Educational Disparities Among Cannabis Users and Cigarette Smokers","authors":"Zechariah Zhu MA ,&nbsp;Samantha Cruz MS ,&nbsp;Thet Nwe Myo Khin MPH ,&nbsp;Yuyan Shi PhD ,&nbsp;Sara B. McMenamin PhD ,&nbsp;Richard F. Armenta PhD, MPH ,&nbsp;Kimberley M. Pulvers PhD, MPH ,&nbsp;Dennis R. Trinidad PhD, MPH","doi":"10.1016/j.focus.2025.100436","DOIUrl":"10.1016/j.focus.2025.100436","url":null,"abstract":"<div><h3>Introduction</h3><div>Previous research has shown an inverse relationship between cigarette smoking and educational attainment. However, there is relatively scarce research on the relationship between cannabis use and education level. This article examines whether the inverse relationship between cigarette smoking and educational attainment applies to cannabis use.</div></div><div><h3>Methods</h3><div>The 2023 California Health Interview Survey, a representative population-based survey of California adults that assesses health behaviors, was analyzed to examine current cigarette smoking and cannabis use prevalence. Logistic regression was used to examine the association between cigarette smoking/cannabis use and educational attainment among adults aged &gt;26 years (N=20,557), adjusting for age, sex, and race/ethnicity.</div></div><div><h3>Results</h3><div>In 2023, among California adults aged &gt;26 years, current cannabis use prevalence was more than twice as high (13.5%) as current cigarette use prevalence (6.1%). Compared to the odds of being a current cannabis user for those who did not graduate high school, the odds were 2.05 times as high (95% CI=1.35, 3.12) for those who completed high school, 2.57 times as high (95% CI=1.73, 3.80) for those with some college education, and 2.17 times as high (95% CI=1.46, 3.23) for those who completed college. Compared to the odds of being a current cigarette smoker for those who did not graduate high school, the odds were 0.31 times as high (95% CI=0.22, 0.43) for those who completed college.</div></div><div><h3>Conclusions</h3><div>Adults with higher education levels were more likely to be cannabis users than those with less education, which was inverse to the relationship between cigarette smoking and education. Efforts to prevent and reduce cannabis use should have additional focus on those who have completed high school and college.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"5 1","pages":"Article 100436"},"PeriodicalIF":0.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lingering Hesitancy: Persistent Uncertainty About the COVID-19 Vaccines Among Previously Vaccinated Individuals","authors":"Francis K. Kazungu MS ,&nbsp;Sinan Almukhtar MD, MPH ,&nbsp;Emily Stiehl PhD ,&nbsp;Manorama M. Khare PhD, MS ,&nbsp;Ronald C. Hershow MD ,&nbsp;Sanjib Basu PhD ,&nbsp;Noah McWhirter MS ,&nbsp;Sage J. Kim PhD","doi":"10.1016/j.focus.2025.100437","DOIUrl":"10.1016/j.focus.2025.100437","url":null,"abstract":"<div><h3>Introduction</h3><div>Routine vaccination is an important public health measure to prevent severe illness from COVID-19. Although the determinants of vaccine hesitancy have been explored in prior research, limited information is available on the varying perceptions of the COVID-19 vaccines among previously vaccinated individuals. This study investigates how individuals previously vaccinated against COVID-19 might develop hesitancy toward future doses, a concept that the authors define as lingering hesitancy.</div></div><div><h3>Methods</h3><div>The authors conducted an online cross-sectional survey with 560 vaccinated respondents in 6 urban Chicago community areas (<em>n</em>=440) and Stephenson County, a rural county in Northern Illinois (<em>n</em>=120), between December 2021 and April 2022. The authors explored the role of an individual’s sociocultural context (i.e., urban/rural setting, political affiliation, and race/ethnicity) in developing lingering hesitancy. Lingering hesitancy was operationalized using 2 constructs: (1) negative COVID-19 vaccine attitudes and (2) COVID-19 vaccine safety concerns. The authors also investigated whether mistrust in the government and institutions as well as barriers to accessing the COVID-19 vaccines mediate the relationship between context and lingering hesitancy.</div></div><div><h3>Results</h3><div>The authors found significantly higher negative attitudes toward the COVID-19 vaccines and higher safety concerns among conservative versus liberal respondents (b=0.37, <em>p</em>&lt;0.001; b=0.21, <em>p</em>&lt;0.01, respectively) and among urban versus rural residents (b=0.45, <em>p</em>&lt;0.001; b=0.37, <em>p</em>&lt;0.001). Black/African American participants reported higher vaccine safety concerns than White participants (mean=2.6 vs 2.4, <em>p</em>&lt;0.05). A significant portion of lingering hesitancy among conservative and Black/African American respondents was mediated by mistrust in the government and institutions. Barriers partially mediated vaccine safety concerns among Hispanic respondents.</div></div><div><h3>Conclusions</h3><div>Most public health efforts aimed at COVID-19 vaccine outreach and messaging have focused on increasing vaccine uptake, thereby targeting unvaccinated individuals. As the focus shifts toward annual COVID-19 vaccinations, it is essential to consider lingering hesitancy among those who have received previous vaccine doses. This article provides a framework for implementing vaccine-messaging campaigns that increase confidence and build trust in routine vaccinations.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"5 1","pages":"Article 100437"},"PeriodicalIF":0.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neighborhood Environment and Late-Life Cognition: Exploring the Mediating Effect of Sleep and Differential Pathways by Race","authors":"Bernadette A. Fausto PhD ,&nbsp;Victoria Paruzel MPH ,&nbsp;Kexin Yu PhD ,&nbsp;Diana Grass BA ,&nbsp;Joshua L. Gills PhD ,&nbsp;Paul R. Duberstein PhD","doi":"10.1016/j.focus.2025.100435","DOIUrl":"10.1016/j.focus.2025.100435","url":null,"abstract":"<div><h3>Introduction</h3><div>Cognition is influenced by the neighborhood social and built environment, but the underlying mechanisms through which neighborhood environments affect cognition are unclear and may differ by race/ethnicity. The authors tested the hypothesis that sleep mediates the association between environmental characteristics and cognition. The authors also explored environment-sleep-cognition interrelationships separately for non-Hispanic White, non-Hispanic Black, and Hispanic older adults in the U.S.</div></div><div><h3>Methods</h3><div>Analyses included older adults from Round 2 of the National Social Life, Health, and Aging Project (N=3,111). The social environment latent variable was constructed using indicators for social cohesion, social ties, and perceived neighborhood danger. The built environment was operationalized using indicators for litter, noise, traffic, pollution, and building conditions. Gross cognitive ability was characterized using the Chicago Cognitive Function Measure as an estimate of Montreal Cognitive Assessment scores. Actigraphic sleep characteristics included sleep fragmentation, time spent awake after sleep onset, and sleep percentage.</div></div><div><h3>Results</h3><div>Participants with better cognition lived in supportive social environments and less hazardous, disruptive (e.g., noisy, polluted) built environments. The sleep mediation hypothesis was partially supported in the full sample: time spent awake after sleep onset mediated the social environment–cognition relationship, but sleep characteristics did not mediate the built environment–cognition relationship. However, in exploratory subgroup analyses, sleep mediated the social environment–cognition relationship among White older adults and mediated the built environment–cognition relationship among Black older adults. Sleep did not mediate any environment–cognition relationships among Hispanic older adults.</div></div><div><h3>Conclusions</h3><div>These results demonstrate that although the social and built environment influence cognition directly and indirectly through sleep, the mediational pathways may vary by specific racial/ethnic subgroups.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"5 1","pages":"Article 100435"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the Impact of Exposure to Different Types of Suicidal Thoughts and Behaviors","authors":"Kimberly J. Mitchell PhD ,&nbsp;Victoria Banyard PhD ,&nbsp;Julie Cerel PhD ,&nbsp;Deirdre Colburn PhD","doi":"10.1016/j.focus.2025.100432","DOIUrl":"10.1016/j.focus.2025.100432","url":null,"abstract":"<div><h3>Introduction</h3><div>This study examines the self-reported life impact of exposure to someone else’s suicidal thoughts and behaviors on the participants, including what type of suicidal thought and behavior exposure (nonsuicidal self-injury, ideation, suicide death, or attempt), incident details, and personal characteristics influence the impact.</div></div><div><h3>Methods</h3><div>Data were collected from 4,981 adolescents and young adults, aged 13–22 years, between June 13, 2022 and October 30, 2023. Of these, 94.7% (<em>n</em>=4,701) knew someone with a suicidal thought or behavior; youth reported up to 2 unique exposures, which resulted in data about 8,133 unique incidents.</div></div><div><h3>Results</h3><div>There were significantly higher odds of feeling a greater life impact (i.e., level of disruption it had on their life) in incidents where the person with the suicidal thought or behavior was a romantic or dating partner (AOR=1.62, <em>p</em>=0.01) or a family member (AOR=1.62, <em>p</em>=0.01). The closer the participant said they were to the person, the higher the odds of more life impact (AOR=1.75, <em>p</em>&lt;0.001). The more additional concerns the participants knew that the person was struggling with, the higher the odds of more life impact (AOR=1.11, <em>p</em>&lt;0.001). Deficits in social determinants of health, specifically economic instability (AOR=1.18, <em>p</em>&lt;0.001) and barriers to mental health care (AOR=1.03, <em>p</em>=0.002), were also related to more life impact.</div></div><div><h3>Conclusions</h3><div>The findings indicated a wide variety of exposures in their social network, and these variables affect the adversity burden associated with knowing someone who is struggling with suicidal thoughts and behaviors. Designing prevention and intervention strategies that address the impact of exposure is an important direction for public health innovations.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"5 1","pages":"Article 100432"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and Practice Behaviors of Community-Based Resident Physicians Surrounding Cancer Screening","authors":"Paige Bentley MS ,&nbsp;Madison Bieganski MS ,&nbsp;Kevin Eells BS ,&nbsp;Zachary Ryan MS ,&nbsp;Isain Zapata PhD ,&nbsp;Joel Roberts MD","doi":"10.1016/j.focus.2025.100427","DOIUrl":"10.1016/j.focus.2025.100427","url":null,"abstract":"<div><h3>Introduction</h3><div>Cancer screening programs have significantly reduced mortality rates associated with cervical, breast, and colorectal cancers over the past few decades. However, inconsistencies in screening guidelines among healthcare providers raise concerns about the uniformity of recommendations.</div></div><div><h3>Methods</h3><div>This study uses a survey to investigate the practice behaviors and knowledge of cancer screening guidelines among medical residents in family medicine, internal medicine, and general surgery community-based residency programs in the state of Colorado. A multi-institution survey was conducted, with 72 resident physicians participating. The study explores the sources from which residents acquire screening guidelines and evaluates their accuracy in recommending screening ages for colorectal, breast, and cervical cancers.</div></div><div><h3>Results</h3><div>Results indicate a preference for guidelines from the U.S. Preventive Services Task Force, although there are variations in recommendations among specialties. Although residents demonstrate good knowledge of cervical cancer screening, they exhibit inconsistencies in breast cancer screening ages. Conflicting guidelines are perceived to impact patients' quality of care and confidence in the healthcare system. Residents primarily learn screening recommendations during medical school, highlighting the importance of early education.</div></div><div><h3>Conclusions</h3><div>The study underscores the need for streamlined and consistent guidelines to mitigate confusion among providers and patients. Further research is recommended to explore the objective impacts of guideline variability on screening practices and patient outcomes.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"5 1","pages":"Article 100427"},"PeriodicalIF":0.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in Receipt of Tobacco Cessation Advice Among U.S. Adult Healthcare Patients Who Use Tobacco","authors":"Nayoung Kim PhD ,&nbsp;Jesse T. Kaye PhD ,&nbsp;Danielle E. McCarthy PhD","doi":"10.1016/j.focus.2025.100431","DOIUrl":"10.1016/j.focus.2025.100431","url":null,"abstract":"<div><h3>Introduction</h3><div>Healthcare systems could reduce disparities in the toll of tobacco use by advising all patients who use tobacco to quit. This study examined U.S. adult population–based estimates of past-year tobacco use and of healthcare provider advice to quit tobacco and disparities in these rates across sociodemographic and substance use characteristics.</div></div><div><h3>Methods</h3><div>Cross-sectional data from the 2015–2019 National Survey on Drug Use and Health were used to estimate the rates of tobacco use and tobacco cessation advice as a function of patient sociodemographic characteristics and other substance use.</div></div><div><h3>Results</h3><div>A total of 28% of U.S. adult healthcare patients reported past-year tobacco use. Only 52% of them recalled receiving tobacco cessation advice from healthcare providers. Tobacco use was elevated among people with co-occurring substance use or disorders; men; non-Hispanic White people; those identifying as lesbian, gay, or bisexual; those with incomes below $30,000; those with no college degree; those in rural areas; and those with non-Medicare or no insurance. Rates of receiving quitting advice were lower among people who use alcohol or cannabis; those with cannabis use disorder; men; minoritized racial/ethnic groups; those with incomes below $30,000; and those in urban areas. Conversely, people with no college degree and public insurance and those with alcohol or illicit drug use disorder reported higher advising rates.</div></div><div><h3>Conclusions</h3><div>Some groups with high tobacco use prevalence receive quitting advice at low rates. Healthcare provider advice to quit tobacco may not reach all patients who use tobacco, particularly those with co-occurring alcohol or cannabis use or cannabis use disorder.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"5 1","pages":"Article 100431"},"PeriodicalIF":0.0,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Benefit-to-Burden Ratios for Stool-Based Colorectal Cancer Screening Tests in the U.S.: A Decision Analytical Modeling Approach","authors":"John B. Kisiel MD ,&nbsp;A. Mark Fendrick MD ,&nbsp;Derek W. Ebner MD ,&nbsp;Michael Dore MD ,&nbsp;Chris Estes MPH ,&nbsp;Vahab Vahdat PhD ,&nbsp;A. Burak Ozbay PhD ,&nbsp;Paul J. Limburg MD","doi":"10.1016/j.focus.2025.100429","DOIUrl":"10.1016/j.focus.2025.100429","url":null,"abstract":"<div><h3>Introduction</h3><div>The U.S. Preventive Services Task Force recommends average-risk colorectal cancer screening beginning at age 45 years with the multitarget stool DNA test at 1–3-year intervals or annual fecal immunochemical tests. In this decision analytical model study, the validated Colorectal Cancer Adenoma Incidence and Mortality model incorporated updated aggregate test performance data to estimate the benefit-to-burden ratio of stool-based screening tests across recommended intervals and age ranges and identify the efficient strategies.</div></div><div><h3>Methods</h3><div>Screening strategies of multitarget stool DNA or fecal immunochemical tests at 1–3-year intervals over various age ranges were evaluated for average-risk individuals in the U.S. Performance inputs for an updated marker panel (next-generation multitarget stool DNA) and fecal immunochemical tests were obtained from a meta-analysis. The primary analysis was an efficient frontier generated for life-years gained (benefit) compared with no screening versus the number of lifetime colonoscopies (burden) for each screening strategy. Strategies are efficient if no other strategy provides more life-years gained with equivalent or fewer colonoscopies and are near efficient if they are within 3 days of life-years gained of the efficient frontier.</div></div><div><h3>Results</h3><div>All screening strategies resulted in positive life-years gained versus no screening (178–352 life-years gained/1,000 individuals). Nine of the 11 efficient strategies started screening at age 45 years. Triennial next-generation multitarget stool DNA between ages 45 and 75 years was the only stool-screening strategy at U.S. Preventive Services Task Force–recommended ages and intervals that was efficient. Recommended strategies of annual fecal immunochemical tests and annual next-generation multitarget stool DNA between ages 45 and 75 years were near efficient.</div></div><div><h3>Conclusions</h3><div>Performance advantages associated with triennial next-generation multitarget stool DNA from ages 45 to 75 years provided the best benefit to burden of the age- and interval-recommended stool-based screening strategies.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"5 1","pages":"Article 100429"},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in Lung Cancer Screening: Demographic and Socioeconomic Influences","authors":"Elie Mulhem MD ,&nbsp;Elkhansa Sidahmed PhD ,&nbsp;Yuying Xing PhD ,&nbsp;Hany Eraqi MD ,&nbsp;Holly MacIntyre DO ,&nbsp;Ramin Homayouni PhD","doi":"10.1016/j.focus.2025.100428","DOIUrl":"10.1016/j.focus.2025.100428","url":null,"abstract":"<div><h3>Introduction</h3><div>Lung cancer is the leading cause of cancer mortality in the U.S. Low-dose computed tomography is recommended for lung cancer screening in high-risk patients. The U.S. Preventive Services Task Force updated its recommendation for lung cancer screening in March 2021 to expand eligibility. This study aims to assess lung cancer screening rates and identify factors influencing lung cancer screening uptake under the new recommendations in Southeast Michigan.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on lung cancer screening–eligible patients from April 2021 to December 2023. Patients’ demographics, clinical, and socioeconomic factors were extracted from electronic medical records. Multivariable logistic regression was used to identify factors associated with lung cancer screening uptake.</div></div><div><h3>Results</h3><div>Of the 42,769 eligible patients, only 9,249 (22%) completed lung cancer screening at least once during the study period. Lung cancer screening rate increased from &lt;10% in the first year to nearly 35% by the end of the study period. Higher uptake was observed in patients aged 60–80 years, females, former smokers, and Asian patients. Lung cancer screening was significantly less likely among patients of Middle Eastern or Arab ethnicity, patients of Black race, Medicaid beneficiaries, and those who lived in deprived ZIP codes.</div></div><div><h3>Conclusions</h3><div>Since U.S. Preventive Services Task Force expanded eligibility criteria, lung cancer screening rates remain suboptimal, with disparities across demographic and socioeconomic groups. Tailored, equitable interventions are critical to increasing screening uptake among high-risk and minority populations.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 6","pages":"Article 100428"},"PeriodicalIF":0.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145363543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}