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文献精选 > 近年高分"单细胞测序"研究（IF≥30，近5年）

Racial and socioeconomic disparities in lung cancer screening in the United States: A systematic review. ​

文献信息 ​

DOI10.3322/caac.21671
PMID34015860
期刊CA: a cancer journal for clinicians
影响因子232.4
JCR 分区Q1
发表年份2021
被引次数65
关键词差异、肺癌、肺癌筛查、种族少数群体、社会经济地位
文献类型Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Systematic Review
ISSN0007-9235
页码299-314
期号71(4)
作者Ernesto Sosa, Gail D'Souza, Aamna Akhtar, Melissa Sur, Kyra Love, Jeanette Duffels, Dan J Raz, Jae Y Kim, Virginia Sun, Loretta Erhunmwunsee

一句话小结 ​

本研究探讨了非小细胞肺癌筛查中存在的种族和社会经济差异，发现黑人及社会经济处于劣势的个体在资格、利用和后续护理等方面错失了筛查的潜在益处，导致死亡率增加。研究强调识别不平等来源的重要性，并建议开展前瞻性试验以改善服务不足群体的筛查和后续护理。

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差异 · 肺癌 · 肺癌筛查 · 种族少数群体 · 社会经济地位

摘要 ​

非小细胞肺癌（NSCLC）是癌症死亡的主要原因。肺癌筛查（LCS）能够降低NSCLC的死亡率；然而，LCS研究中的多样性缺乏可能限制了结果对面临更高风险和更差预后的边缘群体的适用性。识别LCS流程中的不平等来源对于减少NSCLC结果中的差异至关重要。作者搜索了3个主要数据库，寻找2010年1月1日至2020年2月27日间发表的符合以下标准的研究：1）包括年龄在45至80岁之间的现任或前吸烟者；2）使用英语撰写；3）在美国进行；4）讨论与社会经济和种族相关的LCS结果。符合条件的研究被评估了偏倚风险。在筛选的3721项研究中，有21项符合条件。符合条件的研究经过评估，其结果被分类为与黑人和社会经济处于劣势的个体面临的LCS差异相关的3个主题：1）资格；2）利用、感知和效用；3）筛查后行为和护理。LCS的差异存在于种族和社会经济层面。在LCS流程的多个环节中，黑人和社会经济处于劣势的个体错失了LCS的潜在益处，从而导致死亡率增加。本研究识别出需要进一步调查的潜在不平等来源。作者建议实施前瞻性试验，以评估服务不足群体的资格标准，并创建专注于改善利用率和后续护理的干预措施，以减少LCS差异。

英文摘要 ​

Nonsmall cell lung cancer (NSCLC) is the leading cause of cancer deaths. Lung cancer screening (LCS) reduces NSCLC mortality; however, a lack of diversity in LCS studies may limit the generalizability of the results to marginalized groups who face higher risk for and worse outcomes from NSCLC. Identifying sources of inequity in the LCS pipeline is essential to reduce disparities in NSCLC outcomes. The authors searched 3 major databases for studies published from January 1, 2010 to February 27, 2020 that met the following criteria: 1) included screenees between ages 45 and 80 years who were current or former smokers, 2) written in English, 3) conducted in the United States, and 4) discussed socioeconomic and race-based LCS outcomes. Eligible studies were assessed for risk of bias. Of 3721 studies screened, 21 were eligible. Eligible studies were evaluated, and their findings were categorized into 3 themes related to LCS disparities faced by Black and socioeconomically disadvantaged individuals: 1) eligibility; 2) utilization, perception, and utility; and 3) postscreening behavior and care. Disparities in LCS exist along racial and socioeconomic lines. There are several steps along the LCS pipeline in which Black and socioeconomically disadvantaged individuals miss the potential benefits of LCS, resulting in increased mortality. This study identified potential sources of inequity that require further investigation. The authors recommend the implementation of prospective trials that evaluate eligibility criteria for underserved groups and the creation of interventions focused on improving utilization and follow-up care to decrease LCS disparities.

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主要研究问题 ​

  1. 在肺癌筛查中，如何具体评估不同种族和社会经济群体的筛查资格标准？
  2. 影响肺癌筛查利用率的主要因素有哪些，特别是在黑人和社会经济弱势群体中？
  3. 如何改进肺癌筛查后的随访护理，以减少社会经济差异对健康结果的影响？
  4. 目前在肺癌筛查研究中存在哪些主要的偏见和不足，如何解决这些问题以提高研究的普遍适用性？
  5. 在实施针对弱势群体的干预措施时，应该考虑哪些特定的文化和社会经济因素？

核心洞察 ​

研究背景和目的 ​

非小细胞肺癌（NSCLC）是癌症死亡的主要原因。肺癌筛查（LCS）能够降低NSCLC的死亡率，但由于LCS研究中缺乏多样性，可能限制了结果对面临更高风险和更差预后边缘群体的适用性。因此，识别LCS流程中的不平等来源对于减少NSCLC结果的差异至关重要。

主要方法/材料/实验设计 ​

本研究通过系统文献回顾的方法，搜索了三个主要数据库中2010年1月1日至2020年2月27日期间发表的研究。纳入标准包括：

  1. 纳入年龄在45至80岁之间的当前或前吸烟者。
  2. 研究语言为英语。
  3. 研究地点在美国。
  4. 讨论社会经济和种族基础的LCS结果。

在筛选的3721项研究中，最终有21项符合条件。对符合条件的研究进行了偏倚风险评估，并将其发现归类为三个主题，涉及黑人和社会经济弱势群体面临的LCS差异。

Mermaid diagram

关键结果和发现 ​

研究结果显示，LCS在种族和社会经济层面上存在差异。具体发现包括：

  • 资格：黑人和社会经济弱势群体在符合LCS资格方面存在障碍。
  • 利用、认知和效用：这些群体在LCS的利用率、对筛查的认知和感知效用上显著低于其他群体。
  • 筛查后行为和护理：在筛查后，这些群体的随访和护理行为也显著不足，导致潜在的健康益处未能实现。

主要结论/意义/创新性 ​

本研究揭示了LCS流程中黑人和社会经济弱势群体所面临的多个不平等来源，强调了需要进一步研究这些差异的根本原因。研究建议实施前瞻性试验，以评估对弱势群体的资格标准，并创建干预措施，旨在提高这些群体的LCS利用率和后续护理，以减少LCS差异。

研究局限性和未来方向 ​

本研究的局限性包括：

  • 仅纳入了美国的研究，可能无法反映全球范围内的情况。
  • 文献回顾可能未能捕捉到所有相关研究。

未来研究方向建议：

  • 进行更广泛的跨国研究，以探索不同文化和社会经济背景下的LCS差异。
  • 发展和评估针对弱势群体的具体干预措施，以改善其LCS参与度和健康结果。

参考文献 ​

  1. Adherence to colorectal cancer screening: a randomized clinical trial of competing strategies. - John M Inadomi;Sandeep Vijan;Nancy K Janz;Angela Fagerlin;Jennifer P Thomas;Yunghui V Lin;Roxana Muñoz;Chim Lau;Ma Somsouk;Najwa El-Nachef;Rodney A Hayward - Archives of internal medicine (2012)
  2. Perceptions and Utilization of Lung Cancer Screening Among Smokers Enrolled in a Tobacco Cessation Program. - Dan J Raz;Geena Wu;Rebecca A Nelson;Virginia Sun;Su Wu;Angel Alem;Eric C Haupt;Mohamed H Ismail;Michael K Gould - Clinical lung cancer (2019)
  3. Survival disparities in non-small cell lung cancer by race, ethnicity, and socioeconomic status. - Stacey L Tannenbaum;Tulay Koru-Sengul;Wei Zhao;Feng Miao;Margaret M Byrne - Cancer journal (Sudbury, Mass.) (2014)
  4. Mortality, survival and incidence rates in the ITALUNG randomised lung cancer screening trial. - Eugenio Paci;Donella Puliti;Andrea Lopes Pegna;Laura Carrozzi;Giulia Picozzi;Fabio Falaschi;Francesco Pistelli;Ferruccio Aquilini;Cristina Ocello;Marco Zappa;Francesca M Carozzi;Mario Mascalchi; - Thorax (2017)
  5. Do racial or socioeconomic disparities exist in lung cancer treatment? - Relin Yang;Michael C Cheung;Margaret M Byrne;Youjie Huang;Dao Nguyen;Brian E Lally;Leonidas G Koniaris - Cancer (2010)
  6. American Cancer Society lung cancer screening guidelines. - Richard Wender;Elizabeth T H Fontham;Ermilo Barrera;Graham A Colditz;Timothy R Church;David S Ettinger;Ruth Etzioni;Christopher R Flowers;G Scott Gazelle;Douglas K Kelsey;Samuel J LaMonte;James S Michaelson;Kevin C Oeffinger;Ya-Chen Tina Shih;Daniel C Sullivan;William Travis;Louise Walter;Andrew M D Wolf;Otis W Brawley;Robert A Smith - CA: a cancer journal for clinicians (2013)
  7. Social factors, treatment, and survival in early-stage non-small cell lung cancer. - H P Greenwald;N L Polissar;E F Borgatta;R McCorkle;G Goodman - American journal of public health (1998)
  8. Lung cancer risk in white and black Americans. - Steven D Stellman;Yu Chen;Joshua E Muscat;Mirjana V Djordjevic;John P Richie;Philip Lazarus;Seth Thompson;Nasser Altorki;Marianne Berwick;Marc L Citron;Susan Harlap;Tajinder B Kaur;Alfred I Neugut;Sara Olson;John M Travaline;Philip Witorsch;Zuo-Feng Zhang - Annals of epidemiology (2003)
  9. Age at cancer diagnosis for blacks compared with whites in the United States. - Hilary A Robbins;Eric A Engels;Ruth M Pfeiffer;Meredith S Shiels - Journal of the National Cancer Institute (2015)
  10. Reduced lung-cancer mortality with low-dose computed tomographic screening. - ;Denise R Aberle;Amanda M Adams;Christine D Berg;William C Black;Jonathan D Clapp;Richard M Fagerstrom;Ilana F Gareen;Constantine Gatsonis;Pamela M Marcus;JoRean D Sicks - The New England journal of medicine (2011)

引用本文的文献 ​

  1. Evaluation of tumor microenvironmental immune regulation and prognostic in lung adenocarcinoma from the perspective of purinergic receptor P2Y13. - Jiangtao Wang;Weiwei Shi;Yandong Miao;Jian Gan;Quanlin Guan;Juntao Ran - Bioengineered (2021)
  2. A Lung Cancer Screening Education Program Impacts both Referral Rates and Provider and Medical Assistant Knowledge at Two Federally Qualified Health Centers. - Aamna Akhtar;Ernesto Sosa;Samuel Castro;Melissa Sur;Vanessa Lozano;Gail D'Souza;Sophia Yeung;Jonjon Macalintal;Meghna Patel;Xiaoke Zou;Pei-Chi Wu;Ellen Silver;Jossie Sandoval;Stacy W Gray;Karen L Reckamp;Jae Y Kim;Virginia Sun;Dan J Raz;Loretta Erhunmwunsee - Clinical lung cancer (2022)
  3. Socio-Economic Inequalities in Lung Cancer Outcomes: An Overview of Systematic Reviews. - Daniel Redondo-Sánchez;Dafina Petrova;Miguel Rodríguez-Barranco;Pablo Fernández-Navarro;José Juan Jiménez-Moleón;Maria-José Sánchez - Cancers (2022)
  4. Tumor Immune Microenvironment and Immunotherapy in Brain Metastasis From Non-Small Cell Lung Cancer. - Yuchang Wang;Rui Chen;Yue Wa;Shikuan Ding;Yijian Yang;Junbo Liao;Lei Tong;Gelei Xiao - Frontiers in immunology (2022)
  5. Likelihood of Lung Cancer Screening by Poor Health Status and Race and Ethnicity in US Adults, 2017 to 2020. - Alison S Rustagi;Amy L Byers;Salomeh Keyhani - JAMA network open (2022)
  6. A novel classification method for NSCLC based on the background interaction network and the edge-perturbation matrix. - Yuan Tian;Caiqing Zhang;Wanru Ma;Alan Huang;Mei Tian;Junyan Zhao;Qi Dang;Yuping Sun - Aging (2022)
  7. Attitudes towards the integration of smoking cessation into lung cancer screening in the United Kingdom: A qualitative study of individuals eligible to attend. - Samantha Groves;Grace McCutchan;Samantha L Quaife;Rachael L Murray;Jamie S Ostroff;Kate Brain;Philip A J Crosbie;Janelle Yorke;David Baldwin;John K Field;Lorna McWilliams - Health expectations : an international journal of public participation in health care and health policy (2022)
  8. FAST: A Framework to Assess Speed of Translation of Health Innovations to Practice and Policy. - Enola Proctor;Alex T Ramsey;Lisa Saldana;Thomas M Maddox;David A Chambers;Ross C Brownson - Global implementation research and applications (2022)
  9. Health Economics Research in Cancer Screening: Research Opportunities, Challenges, and Future Directions. - Ya-Chen Tina Shih;Lindsay M Sabik;Natasha K Stout;Michael T Halpern;Joseph Lipscomb;Scott Ramsey;Debra P Ritzwoller - Journal of the National Cancer Institute. Monographs (2022)
  10. Evidence of Racial Disparities in the Lung Cancer Screening Process: a Systematic Review and Meta-Analysis. - Yukiko Kunitomo;Brett Bade;Craig G Gunderson;Kathleen M Akgün;Alexandria Brackett;Lynn Tanoue;Lori A Bastian - Journal of general internal medicine (2022)

... (55 更多 篇文献)

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