Lung cancer screening eligibility and use with low‐dose computed tomography: Results from the 2018 Behavioral Risk Factor Surveillance System cross‐sectional survey

Cancer ◽  
2020 ◽  
Author(s):  
Anand K. Narayan ◽  
Yasha Gupta ◽  
Brent P. Little ◽  
Joanne O. Shepard ◽  
Efren J. Flores
Cancer ◽  
2019 ◽  
Vol 125 (23) ◽  
pp. 4158-4163 ◽  
Author(s):  
Randy C. Miles ◽  
Constance D. Lehman ◽  
Sarah F. Mercaldo ◽  
Rulla M. Tamimi ◽  
Brian N. Dontchos ◽  
...  

2020 ◽  
Vol 22 (12) ◽  
pp. 2164-2169
Author(s):  
Justin T Stowell ◽  
Yasha Parikh ◽  
Kimberly Tilson ◽  
Anand K Narayan

Abstract Introduction Transgender and gender diverse (TGD) persons disproportionately face many health disparities including a higher risk of lung cancer. Lung cancer screening (LCS) using low-dose chest computed tomography has reduced lung cancer mortality in eligible high-risk smokers across several large trials, yet utilization of LCS remains low. TGD persons may be less likely to receive recommended cancer screening compared with cisgender populations. We sought to compare eligibility for and utilization of LCS between TGD and cisgender persons in the United States. We also examined if the utilization of LCS varied by smoking status within each gender identity group. Methods We analyzed data from the 2017 and 2018 Behavioral Risk Factor Surveillance System (BRFSS) cross-sectional survey to determine eligibility and utilization of LCS among TGD participants compared with cisgender persons. Logistical regression analysis of potentially confounding variables included age category, race/ethnicity, income, employment status, health insurance, and having a personal doctor. Results Of 37 023 weighted respondents, 0.5% were TGD. Although eligibility for LCS was statistically similar (8.8% TGD vs. 12.2% cisgender) (adjusted odds ratio = 0.81, 95% confidence interval = 0.27–2.39, p = .703), only 2.3% of TGD participants reported obtaining a LCS chest computed tomography versus 17.2% of cisgender participants (adjusted odds ratio = 0.04, 95% confidence interval = 0.01–0.59, p = .019). Smoking status showed no association with LCS utilization among gender identity groups. Conclusions TGD persons may be less likely to receive LCS despite having similar smoking status and eligibility of cisgender persons, suggesting a disparity in utilization of this preventative health service. Implications Targeted efforts to increase LCS utilization and promote smoking cessation for at-risk TGD patients may be warranted.


Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 696
Author(s):  
Jennifer R. Pharr ◽  
Kavita Batra

Research to assess the burden of non-communicable diseases (NCDs) among the transgender population needs to be prioritized given the high prevalence of chronic conditions and associated risk factors in this group. Previous cross-sectional studies utilized unmatched samples with a significant covariate imbalance resulting in a selection bias. Therefore, this cross-sectional study attempts to assess and compare the burden of NCDs among propensity score-matched transgender and cisgender population groups. This study analyzed Behavioral Risk Factor Surveillance System data (2017–2019) using complex weighting procedures to generate nationally representative samples. Logistic regression was fit to estimate propensity scores. Transgender and cisgender groups were matched by sociodemographic variables using a 1:1 nearest neighbor matching algorithm. McNemar, univariate, and multivariate logistic regression analyses were conducted among matched cohorts using R and SPSS version 26 software. Compared with the cisgender group, the transgender group was significantly more likely to have hypertension (31.3% vs. 27.6%), hypercholesteremia (30.8% vs. 23.7%), prediabetes (17.3% vs. 10.3%), and were heavy drinkers (6.7% vs. 6.0%) and smokers (22.4% vs. 20.0%). Moreover, the transgender group was more than twice as likely to have depression (aOR: 2.70, 95% CI 2.62–2.72), stroke (aOR: 2.52 95% CI 2.50–2.55), coronary heart disease (aOR: 2.77, 95% CI 2.74–2.81), and heart attack (aOR: 2.90, 95% CI 2.87–2.94). Additionally, the transgender group was 1.2–1.7 times more likely to have metabolic and malignant disorders. Differences were also found between transgender subgroups compared with the cisgender group. This study provides a clear picture of the NCD burden among the transgender population. These findings offer an evidence base to build health equity models to reduce disparities among transgender groups.


BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e022990 ◽  
Author(s):  
Guang-Ran Yang ◽  
Timothy D Dye ◽  
Dongmei Li

ObjectivesDiabetes mellitus (DM) and metabolic syndrome (MS) are both associated with heart attack. Evidence regarding which condition—MS or DM—is better associated with heart attack, however, is limited. The purpose of this study is to examine DM and MS, and their comparative associations with heart attack, using the 2015 Behavioral Risk Factor Surveillance System (BRFSS).DesignCross-sectional study.MethodsA total of 332 008 subjects aged over 18 years were included in the analysis. All subjects were classified into four groups based on their DM and MS status: neither DM nor MS, DM without MS, MS without DM, and both DM and MS. A weighted hierarchical logistic regression was used to examine the difference between the four groups in their association with the risk of a heart attack.ResultsDifferences in weighted frequency distributions of gender, age category (over 45 years or not), smoking status, education, race, physical activity and daily vegetable and fruit consumption were significantly different across the four groups (p<0.05). The weighted prevalence of heart attack was 5.2% for neither DM nor MS group, 8.5% for DM without MS group, 11.0% for MS without DM group and 16.1% for both DM and MS group. The weighted prevalence of heart attack in MS without DM group was significantly higher than that in the DM without MS group (p<0.01). After adjusting for confounding variables, DM without MS and MS without DM were both found to be independently associated with heart attack compared with those without DM nor MS (DM without MS, OR=2.09; MS without DM, OR=2.58, all p<0.01).ConclusionThe BRFSS 2015 data indicated that MS without DM and DM without MS had comparable effects on heart attack, and the odds of risk are doubled than US adults with neither DM nor MS.


2020 ◽  
pp. 089011712094311 ◽  
Author(s):  
John R. Blosnich ◽  
Elizabeth Karras ◽  
Robert M. Bossarte

Purpose: The aim of this investigation was to document the prevalence and correlates of refusing to answer a US federal health survey item about firearms in the household. Design: The cross-sectional analysis was conducted with 2004 and 2017 Behavioral Risk Factor Surveillance System (BRFSS) survey data from Texas, Oregon, Idaho, California, Kansas, and Utah states whose surveys included items about firearms in the household. Participants: Probability-based samples of adults over the age of 18 (n = 34 488 in 2017 BRFSS; n = 33 136 in 2004 BRFSS). Measures: Dichotomized measure of whether respondents answered versus refused to answer “Are any firearms now kept in or around your home?” Analysis: Weighted multiple logistic regression was used to assess how sociodemographic and health-related characteristics were associated with item refusal. Results: Approximately 1.8% (95% CI: 1.6-2.1) of respondents in 2004 and 3.9% (95% CI: 3.4-4.5) of respondents in 2017 sample refused the firearms item ( P < .01). Men were more likely than women (2004: adjusted odds ratio [aOR] = 1.81, 95% CI: 1.24-2.62; 2017: aOR = 1.60, 95% CI = 1.17-2.18) and Latino/a respondents were less likely than white respondents (2004: aOR = 0.24, 95% CI: 0.10-0.60; 2017: aOR = 0.21, 95% CI: 0.13-0.34) to refuse the firearms question. In 2004, refusal was more likely among older than younger respondents, but in 2017, age was not associated with refusal. Conclusions: Refusal to firearm-related survey items along sociodemographic characteristics warrants further research. Community-informed strategies (eg, focus groups, cognitive testing, in-depth interviews) could improve the context and wording of firearm-related items to maximize response to these items in public health surveys.


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