肺癌查,过度诊断和医疗保健利用:全国性基于人口的研究
So Yeon Kim1, Gerard A Silvestri2, Yeon Wook Kim3
1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.
广泛的,与指导方针不一致的低剂量计算机断层扫描 (LDCT) 查导致肺癌 (LC) 过度诊断,特别是在女性中. 这种趋势增加了医疗保健的使用,但在低风险人群中没有明显的生存益处.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 放射学 放射学是一门学科.
背景情况:
- 对肺癌 (LC) 的低剂量计算机断层扫描 (LDCT) 查可能导致过度诊断,但范围和后果尚不清楚.
- 本研究调查了自主主动,无偿的LDCT查在主要非吸烟人口中的流行情况及其对LC流行病学和医疗保健利用的影响.
研究的目的:
- 检查与指导方针不一致的LDCT查的流行情况.
- 评估这种查对肺癌发病率,死亡率,诊断阶段,生存率和医疗保健利用率的影响.
主要方法:
- 一项全国性的队列研究,利用韩国国家健康信息数据库和医院数据 (1999-2022).
- 分析了170万成年人队列,以估计全国范围内未获得补偿的LDCT查率.
- 结点回归用于评估查,LC发病率,死亡率和医疗保健利用趋势.
主要成果:
- 自主发起的LDCT查在男性和女性中显著增加,远远超过了指南资格.
- 在女性中,局部阶段的LC发病率几乎翻了一番,转向更早的诊断和年轻的年龄.
- 肺部手术,通常没有先前的活检,在女性急剧增加,与查增加相关.
结论:
- 广泛的,与指导方针不一致的LDCT查与肺癌过度诊断和医疗保健利用率增加有关,特别是在女性中.
- 进一步的随机对照试验是必要的,以评估低风险人群查的风险和益处.
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