Lung Cancer Screening Uptake: Analysis of BRFSS 2018
- PDF / 162,158 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 64 Downloads / 176 Views
J Gen Intern Med DOI: 10.1007/s11606-020-06236-9 © Society of General Internal Medicine 2020
findings considered significant at p < 0.05. This study was an analysis of a publicly available, deidentified dataset.
RESULTS INTRODUCTION
In 2013, the United States Preventive Services Task Force (USPSTF) recommended annual low-dose CT (LDCT) screening for high-risk smokers. This recommendation was supported by the National Lung Screening Trial that demonstrated reduced lung cancer mortality with screening.1 Despite this recommendation, few national surveys have included lung cancer screening in their core measures. The National Health Interview Survey (NHIS), conducted every 5 years, found LDCT rates at 3.9% in 2015, compared with 3.3% in 2010, which predated the recommendation.2 The 2017 Behavioral Risk Factor Surveillance Survey (BRFSS) optional lung cancer screening module was distributed in only 11 states, and demonstrated that screening increased to 14.4%.3 At present, there is scant information regarding racial disparities in lung cancer screening. However, historically, there have been racial disparities in other cancer screenings and outcomes. In light of these disparities and limited LDCT screening utilization, examining the racial distribution and characteristics associated with uptake of lung cancer screening is particularly important.
In 2018 BRFSS, 224,679 or 17.7% of 1,273,013 USPSTF criteria–eligible smokers reported annual LDCT screening. We found no significant differences in sex, marital status, race, education, or income between the eligible and screened groups (p > 0.05 for all). We found a higher proportion of respondents with insurance, COPD, and having a PCP in the screened group. The LDCT-eligible cohort (64.83%) had lower rates of colon cancer screening compared with non-eligible (73.90%) (p = 0.002), while breast cancer screening and pneumococcal vaccination were not significantly different (Table 1). Across states, we found Maine had the lowest (8.5%) and Texas the highest (24.3%) screening rates among eligible individuals (p = 0.01). There were too few non-White respondents to accurately compare the screening prevalence between White and Black, Asian, American/Alaskan, Indian, Hispanic, or other individuals in seven out of eight states. No disparities were found in screening rates between White and Black individuals in Maryland.
DISCUSSION METHODS
BRFSS is a telephone health survey of US residents that provides state-level data related to major health conditions. We analyzed 2018 BRFSS data and measured self-reported annual LDCT imaging for lung cancer among individuals eligible according to USPSTF criteria (asymptomatic individuals aged 55 to 80 with a 30 pack-year smoking history who currently smoke or quit within the last 15 years) and other screening services. The lung cancer screening questions were an optional survey module included by eight states and individuals with missing eligibility data were excluded. Data was weighted to match state population estimates. All analysis was co
Data Loading...
