Assessment of potential racial and ethnic differences in Hawaiian lung cancer screening

The results of a cohort study conducted in Hawaii are: lung cancer Post-degradation screening (LCS) completion rates for Native Hawaiians, Pacific Islanders, and Asian individuals and their subgroups.The results were published in JAMA network open..

The authors explain that lung cancer is the leading cause of cancer mortality in the United States, and previous studies of cancer incidence and mortality in individuals of Asian American, Native Hawaiian, and Pacific Islander (AANHPI) have shown these. He added that he showed disproportionate lung cancer incidence and mortality among the groups.

In addition, AANHPI individual cancer data are usually presented collectively and may mask differences between racial subgroups, the authors say.

To better understand LCS completion and follow-up rates for men, women, Asian (China, Philippines, Japan, South Korea) subgroups, Native Hawaiians, and individuals in the Pacific Islands, investigators Kaiser Permanente Hawaii (KPHI) ) Evaluated the data of people registered in. LCS program.

Population-based cohort studies included electronic medical record (EMR) data for members who met the criteria between 2015 and 2019.

All individuals were 65 to 79 years old, had 30 packs of smoking history, and had no cancer. Participants were also currently smokers or quit smoking within the last 15 years and had been diagnosed or treated for lung cancer for at least 5 years.

Smoking is estimated to account for 80% to 90% of all lung cancer cases.

Of the 1030 individuals included in the analysis, 838 (81%) completed LCS. This is defined as the completion of a low-dose computed tomography (LDCT) test based on EMR data. The average (SD) patient was 65.6 (5.8) years old, with 61% being male. “The largest racial and ethnic group was non-Hispanic whites (381 participants) [37.0%]), Native Hawaiians or some Native Hawaiians (186 participants) [18.1%]), And Japanese (146 participants) [14.2%]) ”, The author writes.

Analysis revealed:

• Male and Filipino, Chinese, Japanese, and non-Hispanic Caucasian individuals had a higher proportion of LDCT screening orders than females and individuals in other racial and ethnic groups.
• There was no significant difference in screening completion rates.However, there was a screening completion rate gap of 14% to 15% between groups.
• Asian individuals showed the highest screening completion rates (266 participants) [86%]) Next, Native Hawaiians (149 participants) [80%]) And non-Hispanic Caucasian individuals (305 participants) [80%]), Pacific Islanders (50 participants) [79%]) Individuals and individuals of other racial and ethnic groups (68 participants) [77%]).
• Korean (31 participants) within the Asian subgroup [94%]) And Japanese (129 participants) [88%]) The highest completion rate was for individuals, followed by Chinese individuals (28 participants). [82%]) And Filipino individuals (78 participants) [79%]).
• Of the 54 participants with Lung-Imaging Reporting and Data System (RADS) stage 3 disease, 93% (50 participants) completed the 6-month surveillance LDCT test.
• Of the 37 individuals with Lung-RADS stage 4 disease, 35 (97%) were followed up for additional procedures.

Low screening rates can be due to a variety of factors, including lack of insurance, long distances to screening sites, and low income levels. “Social and behavioral factors associated with LCS participation by race and ethnic group and gender need to be further investigated among subdivided race and ethnic groups to identify target groups and areas of intervention. There is, “the author writes.

To promote fairness in female screening eligibility, researchers are working on future studies with the United States Preventive Services Task Force. Updated the guidelines.

The small sample size marks the limits of current research, as researchers have not been able to fully examine racial and ethnic differences and diagnostic results.

“The breakdown of these racial and ethnic groups is more to enable us to validate our findings and dig deeper into the social and behavioral factors that may be associated with LCS completion rates. It will be needed for future studies involving large samples, “the author concludes.

“It is a care delivery system for developing targeted, culturally sensitive interventions that informs work to reduce racial and ethnic disparities that may exist in LCS. We provide specific guidance to you, “they said.

reference

Oshiro CES, Frankland TB, Mor J, etc. Lung cancer screening by race and ethnicity in Hawaii’s integrative medicine system. JAMA Netw Open.. Published online January 20, 2022. doi: 10.1001 / jamanetworkopen.2021.44381