Interventions Designed to Increase the Uptake of Lung Cancer Screening: An Equity-Oriented Scoping Review

Sayani, Ambreen; Ali, Muhanad Ahmed; Dey, Pooja; Corrado, Ann Marie; Ziegler, Carolyn; Nicholson, Erika; Lofters, Aisha

doi:10.1016/j.jtocrr.2023.100469

Cited by 4 publications

(4 citation statements)

References 61 publications

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“…These results provide evidence on a topic very little investigated in our country and indicate that future steps should to be taken to mitigate these disparities. For instance, in accordance with a recent literature review, the implementation of targeted populations interventions, such as those raising community awareness, or providing tailored sociocultural materials, or considering costs related to participation [53] may improve access to lung cancer screening in our country.…”

Section: Discussionmentioning

confidence: 78%

Investigating socioeconomic disparities in lung cancer diagnosis, treatment and mortality: an Italian cohort study

Servadio,

Rosa,

Addis

et al. 2024

BMC Public Health

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Background Lung cancer is one of the most lethal cancers worldwide and patient clinical outcomes seem influenced by their socioeconomic position (SEP). Since little has been investigated on this topic in the Italian context, our aim was to investigate the role of SEP in the care pathway of lung cancer patients in terms of diagnosis, treatment and mortality. Methods This observational retrospective cohort study included patients discharged in the Lazio Region with a lung cancer diagnosis between 2014 and 2017. In the main analysis, educational level was used as SEP measure. Multivariate models, adjusted for demographic and clinical variables, were applied to evaluate the association between SEP and study outcomes, stratified for metastatic (M) and non-metastatic (NM) cancer. We defined a diagnosis as 'delayed' when patients received their initial cancer diagnosis after an emergency department admission. Access to advanced lung cancer treatments (high-cost, novel and innovative treatments) and mortality were investigated within the 24-month period post-diagnosis. Moreover, two additional indicators of SEP were examined in the sensitivity analysis: one focusing on area deprivation and the other on income-based exemption. Results A total of 13,251 patients were identified (37.3% with metastasis). The majority were males (> 60%) and over half were older than 70 years. The distribution of SEP levels among patients was as follow: 31% low, 29% medium–low, 32% medium–high and 7% high. As SEP increased, the risks of receiving a delayed diagnosis ((high vs low: M: OR = 0.29 (0.23–0.38), NM: OR = 0.20 (0.16–0.25)) and of mortality ((high vs low M: OR = 0.77 (0.68–0.88) and NM: 0.61 (0.54–0.69)) decreased. Access to advanced lung cancer treatments increased in accordance with SEP only in the M cohort (high vs low: M: OR = 1.57 (1.18–2.09)). The primary findings were corroborated by sensitivity analysis. Conclusions Our study highlighted the need of public health preventive and educational programs in Italy, a country where the care pathway of lung cancer patients, especially in terms of diagnosis and mortality, appears to be negatively affected by SEP level.

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Section: Discussionmentioning

confidence: 78%

Investigating socioeconomic disparities in lung cancer diagnosis, treatment and mortality: an Italian cohort study

Servadio,

Rosa,

Addis

et al. 2024

BMC Public Health

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“…• underpinning differences in health risk are based on the avoidable and unequal distribution of the SDH; • access (opportunity to have individual healthcare needs met) is multi-faceted and to increase utilization, care must be approachable, acceptable, available, affordable and appropriate (Khanassov et al 2016;Sayani et al 2023); • the responsibility to improve the quality and distribution of the SDH and to ensure equitable utilization of care lies with the system and not with individuals who are being structurally underserved; and • a gradient of inequity exists within underserved populations based on factors such as geographical location, socio-economic status, cultural diversity, historical injustices and cultural practices, resulting in a spectrum of structured disadvantage across populations that require tailored and targeted interventions to address these varying degrees of inequity.…”

Section: Defining Underservedmentioning

confidence: 99%

Defining “Essential Digital Health for the Underserved”

Ho,

Adams,

Sayani

et al. 2024

hcpap

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The World Health Organization envisions achieving "Health for All," to strive for equitable access to important health information and services to attain wellness (WHO 2023a). The COVID-19 pandemic reshaped the Canadian health system toward increasing digital health services, which improved access for some but underserved others. Integrating digital health into holistic health services delivery deserves careful consideration. This paper introduces the concept of "essential digital health for the underserved," by first defining the terms " digital health," "essential" and "underserved." Then, we share a summary of a discussion at a May 2023 conference with stakeholders, including patients, caregivers, health professionals, health policy makers, private sectors and health researchers. A series of papers follow to explore

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“…The Liverpool Lung Health Check invited individuals with a documented history of smoking or diagnosis of COPD recorded in primary care records, an approach that led to 40% uptake in the first round of the pilot programme, which suggests that electronic primary care records can aid recruitment to screening and stresses the importance of accurate smoking data [97]. In a recent review, interventions that were most effective in improving access to lung cancer screening targeted priority populations, raised community-level awareness, tailored materials for sociocultural acceptability, did not depend on prior patient engagement/registration with the health care system, proactively considered costs related to participation, and enhanced utilization through informed decision-making [98].…”

Section: Situation In Europementioning

confidence: 99%

Current Evidence for a Lung Cancer Screening Program

Guerreiro,

Aguiar,

Araújo

2024

Port J Public Health

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Background: Lung cancer screening is still in an early phase compared to other cancer screening programs, despite its high lethality particularly when diagnosed late. Achieving early diagnosis is crucial to obtain optimal outcomes. Summary: In this review, we will address the current evidence on lung cancer screening through low-dose computed tomography (LDCT) and its impact on mortality reduction, existing screening recommendations, patient eligibility criteria, screening frequency and duration, benefits and harms, cost-effectiveness and some insights on lung cancer screening implementation and adoption. Additionally, new non-imaging, noninvasive biomarkers with high diagnostic potential are also briefly highlighted. Key Messages: LDCT screening in a prespecified population based on age and smoking history proved to reduce lung cancer mortality. Optimization of the target population and management of LDCT pitfalls can further improve lung cancer screening efficiency and cost-effectiveness. Novel screening technologies and biomarkers being studied can potentially be game-changers in lung cancer screening and diagnosis.

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Interventions Designed to Increase the Uptake of Lung Cancer Screening: An Equity-Oriented Scoping Review

Cited by 4 publications

References 61 publications

Investigating socioeconomic disparities in lung cancer diagnosis, treatment and mortality: an Italian cohort study

Investigating socioeconomic disparities in lung cancer diagnosis, treatment and mortality: an Italian cohort study

Defining “Essential Digital Health for the Underserved”

Current Evidence for a Lung Cancer Screening Program

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