Lung Cancer Screening Among U.S. Military Veterans by Health Status and Race and Ethnicity, 2017–2020: A Cross-Sectional Population-Based Study

Rustagi, Alison S; Byers, Amy L.; Brown, J. K. M.; Purcell, Natalie; Slatore, Christopher G.; Keyhani, Salomeh

doi:10.1016/j.focus.2023.100084

Cited by 4 publications

(2 citation statements)

References 51 publications

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“…Despite the United States Preventive Task Force (USPSTF) recommending lung cancer screening (LCS) for high-risk people since 2013, overall uptake remains low with Black people undergoing LCS at even lower rates than White people [12,13 ▪ ]. Barriers persist throughout the screening continuum from initial selection, to LCS access, and follow-through with subsequent testing.…”

Section: Disparities In Lung Cancer Screeningmentioning

confidence: 99%

Disparities across the continuum of lung cancer care: a review of recent literature

Kearney,

Nguyen,

Steiling

2024

Current Opinion in Pulmonary Medicine

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Purpose of review Lung cancer remains the leading cause of cancer mortality worldwide. Health disparities have long been noted in lung cancer incidence and survival and persist across the continuum of care. Understanding the gaps in care that arise from disparities in lung cancer risk, screening, treatment, and survivorship are essential to guiding efforts to achieve equitable care. Recent findings Recent literature continues to show that Black people, women, and people who experience socioeconomic disadvantage or live in rural areas experience disparities throughout the spectrum of lung cancer care. Contributing factors include structural racism, lower education level and health literacy, insurance type, healthcare facility accessibility, inhaled carcinogen exposure, and unmet social needs. Promising strategies to improve lung cancer care equity include policy to reduce exposure to tobacco smoke and harmful pollutants, more inclusive lung cancer screening eligibility criteria, improved access and patient navigation in lung cancer screening, diagnosis and treatment, more deliberate offering of appropriate surgical and medical treatments, and improved availability of survivorship and palliative care. Summary Given ongoing disparities in lung cancer care, research to determine best practices for narrowing these gaps and to guide policy change are an essential focus of future lung cancer research.

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Section: Disparities In Lung Cancer Screeningmentioning

confidence: 99%

Disparities across the continuum of lung cancer care: a review of recent literature

Kearney,

Nguyen,

Steiling

2024

Current Opinion in Pulmonary Medicine

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“…Lung cancer is characterized by the presence of thymic, lymphnode, vascular, connective, or neurogenic tumors in the lung, pleura, or mediastinum, which are caused by mutations that commonly affect epidermal growth factor receptor (EGRF), kristen rat sarcoma viral oncogene (KRAS), phosphatidylinositol-4,5-biphosphate 3kinase catalytic subunit alpha (PIK3A), and PTEN (Bironzo et al, 2022). Although the estimated heritability of these mutations is 18% (Rifkin et al, 2023), most lung cancer cases are triggered by smoking (Rustagi et al, 2023). Individuals affected by this disease present a cluster of symptoms encompassed by chest pain, fatigue, sleep deprivation, cough, dyspnea, hemoptysis, and weight loss (Ruano-Raviña et al, 2020;Luo et al, 2023).…”

Section: Lung Cancermentioning

confidence: 99%

Applications of nanotechnologies for miRNA-based cancer therapeutics: current advances and future perspectives

Bravo-Vázquez,

Méndez-García,

Rodríguez

et al. 2023

Front. Bioeng. Biotechnol.

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MicroRNAs (miRNAs) are short (18–25 nt), non-coding, widely conserved RNA molecules responsible for regulating gene expression via sequence-specific post-transcriptional mechanisms. Since the human miRNA transcriptome regulates the expression of a number of tumor suppressors and oncogenes, its dysregulation is associated with the clinical onset of different types of cancer. Despite the fact that numerous therapeutic approaches have been designed in recent years to treat cancer, the complexity of the disease manifested by each patient has prevented the development of a highly effective disease management strategy. However, over the past decade, artificial miRNAs (i.e., anti-miRNAs and miRNA mimics) have shown promising results against various cancer types; nevertheless, their targeted delivery could be challenging. Notably, numerous reports have shown that nanotechnology-based delivery of miRNAs can greatly contribute to hindering cancer initiation and development processes, representing an innovative disease-modifying strategy against cancer. Hence, in this review, we evaluate recently developed nanotechnology-based miRNA drug delivery systems for cancer therapeutics and discuss the potential challenges and future directions, such as the promising use of plant-made nanoparticles, phytochemical-mediated modulation of miRNAs, and nanozymes.

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Prediction-Augmented Shared Decision-Making and Lung Cancer Screening Uptake

Caverly,

Wiener,

Kumbier

et al. 2024

JAMA Netw Open

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ImportanceAddressing poor uptake of low-dose computed tomography lung cancer screening (LCS) is critical, especially for those having the most to gain—high-benefit persons with high lung cancer risk and life expectancy more than 10 years.ObjectiveTo assess the association between LCS uptake and implementing a prediction-augmented shared decision-making (SDM) tool, which enables clinicians to identify persons predicted to be at high benefit and encourage LCS more strongly for these persons.Design, Setting, and ParticipantsQuality improvement interrupted time series study at 6 Veterans Affairs sites that used a standard set of clinical reminders to prompt primary care clinicians and screening coordinators to engage in SDM for LCS-eligible persons. Participants were persons without a history of LCS who met LCS eligibility criteria at the time (aged 55-80 years, smoked ≥30 pack-years, and current smoking or quit &lt;15 years ago) and were not documented to be an inappropriate candidate for LCS by a clinician during October 2017 through September 2019. Data were analyzed from September to November 2023.ExposureDecision support tool augmented by a prediction model that helps clinicians personalize SDM for LCS, tailoring the strength of screening encouragement according to predicted benefit.Main outcome and measureLCS uptake.ResultsIn a cohort of 9904 individuals, the median (IQR) age was 64 (57-69) years; 9277 (94%) were male, 1537 (16%) were Black, 8159 (82%) were White, 5153 (52%) were predicted to be at intermediate (preference-sensitive) benefit and 4751 (48%) at high benefit, and 1084 (11%) received screening during the study period. Following implementation of the tool, higher rates of LCS uptake were observed overall along with an increase in benefit-based LCS uptake (higher screening uptake among persons anticipated to be at high benefit compared with those at intermediate benefit; primary analysis). Mean (SD) predicted probability of getting screened for a high-benefit person was 24.8% (15.5%) vs 15.8% (11.8%) for a person at intermediate benefit (mean absolute difference 9.0 percentage points; 95% CI, 1.6%-16.5%).Conclusions and RelevanceImplementing a robust approach to personalized LCS, which integrates SDM, and a decision support tool augmented by a prediction model, are associated with improved uptake of LCS and may be particularly important for those most likely to benefit. These findings are timely given the ongoing poor rates of LCS uptake.

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Lung Cancer Screening Among U.S. Military Veterans by Health Status and Race and Ethnicity, 2017–2020: A Cross-Sectional Population-Based Study

Cited by 4 publications

References 51 publications

Disparities across the continuum of lung cancer care: a review of recent literature

Disparities across the continuum of lung cancer care: a review of recent literature

Applications of nanotechnologies for miRNA-based cancer therapeutics: current advances and future perspectives

Prediction-Augmented Shared Decision-Making and Lung Cancer Screening Uptake

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