糖心vlog

Lung cancer is the leading cause of cancer death in the US.¹ Through routine screening with low-dose computed tomography (LDCT), LC mortality can be averted.² Current guidelines recommend lung cancer screening (LCS) for 50- to 80-year-old high-risk individuals (ie, former or current smoking), approximating 13 million LCS-eligible US individuals.^3,4 However, in 2022, only 4.5% of LCS-eligible individuals were up to date according to the American Lung Association (ALA).⁵ Discussion about LCS with eligible individuals is foundational for LCS uptake. However, LCS communication by health care practitioners with high-risk adults remains unclear.⁶ The objective of this study was to examine LCS communication for US individuals at high risk by smoking status and demographic, socioeconomic, and clinical characteristics.

This cross-sectional study analyzed data for participants aged 50 to 80 years from the 2022 Health Information National Trends Survey (HINTS)鈥�6, a nationally representative survey of the civilian noninstitutionalized population conducted by the US National Cancer Institute. The HINTS-6 was administered using a mixed-mode (web- and paper-based) method; the overall response rate was 28.15%. This study was deemed exempt by the institutional review board at The Medical University of South Carolina because the data are deidentified and publicly available, in accordance with 45 CFR 搂46. Smoking status, sociodemographics, and clinical information are self-reported by participants. Participants with information on smoking status and who had at least 1 primary health care visit in the past year were identified. Participants were asked, 鈥淎t any time in the past year, did a doctor or other health professional talk with you about having LDCT scan to check for lung cancer?鈥� Participant responses 鈥淚 have never heard of this test鈥� and 鈥淣o鈥� were analyzed separately by smoking status. Combined estimates (never heard of LCS or not discussed LCS with a clinician) were also examined by smoking status. We followed the reporting guidelines. See the eMethods in Supplement 1 for statistical analysis.

A total of 929 participants (estimated population size, 29.0 million) who formerly smoked and 350 participants (11.9 million) who currently smoke were identified. Among those who formerly smoked, 18.1% (95% CI, 14.8%-21.5%) had never heard of LCS and 75.1% (95% CI, 70.8%-79.4%) never discussed LCS with their clinician (Figure). In the currently smoking group, 13.5% (95% CI, 7.7% to 19.4%) had never heard of LCS and 71.1% (95% CI, 63.2%-78.9%) did not discuss it with their clinician. Collectively, more than 80% of participants in both groups, regardless of sex, race, ethnicity, educational attainment, household income, urbanicity vs rurality, health insurance status, and unmet social determinants, had neither heard of LCS nor discussed LCS with a clinician (Table). Over 60% of individuals with a history of cancer or a comorbid lung did not discuss LCS with their clinicians.

This nationally representative cross-sectional study revealed that less than 16% of high-risk individuals had heard of LCS or discussed LCS with a health care practitioner. We also found that lack of LCS communication is pervasive across all sociodemographic and clinical subgroups. These findings are troubling because 13.1 million individuals meet the LCS eligibility criteria (ie, 20 pack-years and <15 years since quitting).⁴ Our data emphasize the need for increasing LCS communication in the US, specifically, increasing education and outreach to eligible individuals who can benefit from LCS. Limitations of HINTS include the cross-sectional nature, which precludes making causal inferences and the lack of availability of pack-years and years since quitting information. Nevertheless, our findings are consistent with a recent ALA survey that reported gaps in clinician LCS communication (73% never discussed their risk with a doctor) and LCS awareness (62% not familiar with the test) in the US.⁶ Implementing informational interventions at the clinic or community level could help improve LCS awareness and facilitate shared decision-making between eligible patients and health care practitioners.

Accepted for Publication: September 11, 2024.

Published: November 4, 2024. doi:10.1001/jamanetworkopen.2024.42811

Open Access: This is an open access article distributed under the terms of the CC-BY License. 漏 2024 Sonawane K et al. 糖心vlog Open.

Corresponding Author: Kalyani Sonawane, PhD, Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, 132 Cannon St, Room CS 303D, Charleston, SC 29464 (sonawane@musc.edu).

Author Contributions: Drs Sonawane and Garg had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Sonawane, Garg, Deshmukh.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Sonawane, Garg.

Critical review of the manuscript for important intellectual content: All authors.

Statistical analysis: Sonawane, Garg, Deshmukh.

Administrative, technical, or material support: Sonawane, Garg.

Supervision: Sonawane, Toll.

Conflict of Interest Disclosures: Dr Sonawane reported receiving personal fees from Value Analytics Labs outside the submitted work. Dr Toll reported receiving personal fees for providing expert testimony in litigation against the tobacco industry outside the submitted work. Dr Deshmukh reported receiving personal fees from Value Analytics Labs and Merck outside the submitted work. No other disclosures were reported.

Funding/Support: The research reported in this publication was supported by Hollings Cancer Center鈥檚 postdoctoral fellowship and the US National Institutes of Health under award number P30CA138313.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Data Sharing Statement: See Supplement 2.