Capacity constraints and disparities in the scale-up of lung cancer CT screening

扩大肺癌CT筛查的能力限制和差异

• 批准号: 8683338
• 负责人: Fabrice Smieliauskas
• 金额: $ 7.9万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8683338
• 关键词: Address; Adult; Advisory Committees; Age; Area; Attention; Cessation of life; Clinical; Clinical Trials; Colorectal Cancer; Country; Data; Dimensions; Dose; Effectiveness; Evidence based intervention; Face; Funding; Future; Geographic Distribution; Geographic Information Systems; Health; Health system; Intervention; Lead; Life; Link; Lung; Malignant Neoplasms; Malignant neoplasm of lung; Mammography; Maps; Measures; Outcome; Population; Positioning Attribute; Preventive; Process; Public Health; Public Health Practice; Recommendation; Recording of previous events; Relative (related person); Reporting; Research; Rural; Screening for cancer; Services; Smoker; Smoking; Statistical Models; Subgroup; Surveys; Time; Tomography, Computed, Scanners; Translations; United States; United States Agency for Healthcare Research and Quality; United States National Institutes of Health; Visual; X-Ray Computed Tomography; anticancer research; attributable mortality; base; clinical practice; colorectal cancer screening; evidence base; geographic difference; lung cancer screening; malignant breast neoplasm; mortality; population based; programs; public health relevance; scale up; screening; socioeconomics

DESCRIPTION (provided by applicant): Thousands of avoidable cancer deaths occur every year in the United States because evidence-based cancer screening interventions get "lost in translation" in the process between discovery and widespread public health and clinical practice. Lung cancer screening holds great potential to reduce cancer deaths, given the recent evidence of effectiveness of screening and the numbers of deaths attributable to lung cancer, but there has been little study of how capacity constraints in the health system might slow these efforts, as they have in screening for other cancers. To address how capacity might influence the scale-up of lung cancer screening, we propose to generate estimates of geographic variation in the number of heavy smokers from 2010-2011 population-based surveys, as well as measures of local clinical and public health system capacity derived from a diverse set of administrative and survey data from 2008-2012 on facilities, CT scanners, health workers, and public health programs. Superimposing these data maps of capacity and of the screening population, we specifically intend: 1. using multiple dimensions of lung screening capacity, to determine the proportion of the nation's heavy smokers living in areas that face capacity constraints to scaling up a program of lung cancer screening. This would reflect the geographic distribution of screening capacity and of the population of heavy smokers, as well as differences between the two. 2. To identify potential disparities in access to lung cancer screening that may emerge across racial, socioeconomic, rural/urban, and educational lines due to the geographic variation in capacity constraints. Disparities in access to screening for other cancers can be substantial, and may be intensified in lung cancer due to higher smoking rates among vulnerable subgroups.

描述（由申请人提供）：美国每年都会发生数以千计的可避免的癌症死亡，因为基于证据的癌症筛查干预措施在发现和广泛的公共卫生和临床实践之间的过程中“迷失在转化中”。鉴于最近有证据表明筛查的有效性和肺癌死亡人数，肺癌筛查在减少癌症死亡方面具有巨大潜力，但很少有研究表明卫生系统的能力限制可能会减缓这些努力，因为它们具有筛查其他癌症的能力。 为了解决能力如何影响肺癌筛查规模的扩大，我们建议根据 2010-2011 年基于人口的调查来估计重度吸烟者数​​量的地理差异，以及当地临床和公共卫生系统能力的衡量标准源自 2008 年至 2012 年有关设施、CT 扫描仪、卫生工作者和公共卫生计划的各种行政和调查数据。将这些能力和筛查人群的数据图叠加起来，我们特别希望： 1. 使用肺部筛查能力的多个维度，确定全国生活在面临能力限制的地区的重度吸烟者的比例，以扩大肺癌计划筛选。这将反映筛查能力和重度吸烟者人口的地理分布，以及两者之间的差异。 2. 确定由于能力限制的地理差异，不同种族、社会经济、农村/城市和教育背景下可能出现的肺癌筛查机会的潜在差异。在其他癌症筛查方面的差异可能很大，并且由于弱势群体中吸烟率较高，肺癌方面的差异可能会更大。