National Lung Cancer Screening Utilization Trends in the Veterans Health Administration.
Journal
JNCI cancer spectrum
ISSN: 2515-5091
Titre abrégé: JNCI Cancer Spectr
Pays: England
ID NLM: 101721827
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
03
03
2020
revised:
20
05
2020
accepted:
08
06
2020
entrez:
25
1
2021
pubmed:
26
1
2021
medline:
26
1
2021
Statut:
epublish
Résumé
Many Veterans are high risk for lung cancer. Low-dose computed tomography (LDCT) is an effective strategy for lung cancer early detection in a high-risk population. Our objective was to describe and compare annual and geographic utilization trends for LDCT screening in the Veteran's Health Administration (VHA). A national retrospective cohort of screened Veterans from January 1, 2011 to May 31, 2018 was used to calculate annual and regional rates of initial LDCT utilization per 1000 eligible Veterans. We identified Veterans with a first LDCT exam using common procedure terminology codes G0297 or 71250 and described as "lung cancer screening," "screening," or "LCS." The number of screen-eligible Veterans per year was calculated as unique Veterans aged 55 to 80 years seen at a Veterans Affairs medical center (VAMC) in that year, multiplied by 32% (estimated proportion with eligible smoking history). We present 95% confidence intervals (CI) for rates. Screened Veterans had a mean age of 66.1 years (standard deviation [SD] = 5.6); 95.5% male; 77.4% Caucasian. There were 119 300 LDCT exams, of which 80 819 (67.7%) were initial. Nationally, initial screens increased from 0 (95% CI = 0.00 to 0.00) in 2011 to 29.6 (95% CI = 29.26 to 29.88) scans per 1000 eligible Veterans in 2018 ( VHA LDCT utilization increased from 2011 to 2018. However, overall utilization remained low. Future interventions are needed to increase lung cancer screening utilization among eligible Veterans.
Sections du résumé
BACKGROUND
BACKGROUND
Many Veterans are high risk for lung cancer. Low-dose computed tomography (LDCT) is an effective strategy for lung cancer early detection in a high-risk population. Our objective was to describe and compare annual and geographic utilization trends for LDCT screening in the Veteran's Health Administration (VHA).
METHODS
METHODS
A national retrospective cohort of screened Veterans from January 1, 2011 to May 31, 2018 was used to calculate annual and regional rates of initial LDCT utilization per 1000 eligible Veterans. We identified Veterans with a first LDCT exam using common procedure terminology codes G0297 or 71250 and described as "lung cancer screening," "screening," or "LCS." The number of screen-eligible Veterans per year was calculated as unique Veterans aged 55 to 80 years seen at a Veterans Affairs medical center (VAMC) in that year, multiplied by 32% (estimated proportion with eligible smoking history). We present 95% confidence intervals (CI) for rates.
RESULTS
RESULTS
Screened Veterans had a mean age of 66.1 years (standard deviation [SD] = 5.6); 95.5% male; 77.4% Caucasian. There were 119 300 LDCT exams, of which 80 819 (67.7%) were initial. Nationally, initial screens increased from 0 (95% CI = 0.00 to 0.00) in 2011 to 29.6 (95% CI = 29.26 to 29.88) scans per 1000 eligible Veterans in 2018 (
CONCLUSION
CONCLUSIONS
VHA LDCT utilization increased from 2011 to 2018. However, overall utilization remained low. Future interventions are needed to increase lung cancer screening utilization among eligible Veterans.
Identifiants
pubmed: 33490864
doi: 10.1093/jncics/pkaa053
pii: pkaa053
pmc: PMC7583162
doi:
Types de publication
Journal Article
Langues
eng
Pagination
pkaa053Informations de copyright
Published by Oxford University Press 2020.
Références
N Engl J Med. 2011 Aug 4;365(5):395-409
pubmed: 21714641
Ann Intern Med. 2014 Mar 4;160(5):330-8
pubmed: 24378917
Am J Prev Med. 2018 Apr;54(4):568-575
pubmed: 29429606
J Thorac Imaging. 2015 Mar;30(2):115-29
pubmed: 25658476
Tob Control. 2010 Dec;19(6):507-11
pubmed: 20870742
JAMA Neurol. 2018 Apr 1;75(4):419-427
pubmed: 29404578
Radiology. 2006 Oct;241(1):55-66
pubmed: 16990671
Ann Intern Med. 2014 Oct 21;161(8):597-8
pubmed: 25111673
Prev Med Rep. 2017 Jan 26;6:17-22
pubmed: 28210538
Clin Lung Cancer. 2017 Nov;18(6):e417-e423
pubmed: 28648531
Prev Chronic Dis. 2015 Jul 09;12:E108
pubmed: 26160294
JAMA. 1999 Oct 20;282(15):1458-65
pubmed: 10535437
Mil Med. 2009 Jan;174(1):29-34
pubmed: 19216295
JAMA Intern Med. 2017 Mar 1;177(3):399-406
pubmed: 28135352
Clin Gastroenterol Hepatol. 2014 Dec;12(12):1973-80
pubmed: 24095973
MMWR Morb Mortal Wkly Rep. 2018 Jan 12;67(1):7-12
pubmed: 29324732
Risk Manag Healthc Policy. 2018 Jan 22;10:189-195
pubmed: 29403320
BMJ. 2008 May 3;336(7651):1016-9
pubmed: 18456633
Prev Med Rep. 2018 May 22;11:93-99
pubmed: 29984145
Ann Am Thorac Soc. 2016 Nov;13(11):1977-1982
pubmed: 27676369
Cancer Control. 2018 Jan-Dec;25(1):1073274818806900
pubmed: 30375235
Cancer Epidemiol Biomarkers Prev. 2015 Apr;24(4):664-70
pubmed: 25613118
Ann Am Thorac Soc. 2017 Aug;14(8):1320-1325
pubmed: 28406708
J Gen Intern Med. 2010 Feb;25(2):147-9
pubmed: 19894079
JAMA Oncol. 2017 Sep 1;3(9):1278-1281
pubmed: 28152136
Ann Am Thorac Soc. 2018 Jan;15(1):69-75
pubmed: 28933940
J Natl Compr Canc Netw. 2019 Apr 1;17(4):339-346
pubmed: 30959463