在被查肺癌的个体中,并发症的负担较大
Dejana Braithwaite1,2,3, Shama Karanth1,2, Christopher G Slatore4,5,6
1Division of Population Health Sciences, Department of Surgery, University of Florida College of Medicine, Gainesville.
在临床环境中接受肺癌查的患者比临床试验中的患者更老,更生病,更多样化. 这些共同疾病和脆弱性的差异可能会改变查的风险效益平衡.
科学领域:
- 肺部医学 肺部医学
- 在瘤学瘤学.
- 公共卫生 公共卫生
背景情况:
- 低剂量计算机断层扫描 (LDCT) 在特定人群中降低了肺癌死亡率.
- 在现实世界肺癌查中的并发症概况尚未得到充分理解.
- 现有的试验数据可能无法反映临床实践中的不同患者群体.
研究的目的:
- 为了比较临床环境 (个性化肺癌查 (PLuS) 队列) 中的患者的并发病概况,与临床试验 (国家肺癌查试验 (NLST)) 中的患者进行比较.
主要方法:
- 从2016年至2021年对LDCT肺癌查的多中心队列研究.
- 在PLuS和NLST队列之间,详细的并发症数据,肺功能和注册表数据的比较.
- 分析电子健康记录和机构/SEER/国家登记册.
主要成果:
- 与NLST相比,PLuS队列年龄较大 (49.0% vs 26.6% ≥65岁) 并且在种族/种族上更多样 (23.3% vs 8.5% 少数民族).
- 在PLuS中,并发症的发病率更高:慢性肺炎 (32.7%与17.5%相比),糖尿病 (24.6%与9.7%相比),心脏病 (15.9%与12.9%相比).
- 在PLuS中注意到显著的多病症,虚弱和心肺功能受损,特别是在老年人中.
结论:
- 临床肺癌查人群比试验人群更多样化,并具有更高的并发症负担.
- 在临床环境中,年龄较大和并发病率较高可能会改变LDCT查的风险-益处概况.
- 研究结果表明,NLST衍生的好处可能不会直接转化为现实世界的临床实践.
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