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ABSTRACT: Background
Many Veterans are high risk for lung cancer. Low-dose computed tomography (LDCT) is an effective strategy for lung cancer early detection in a high-risk population. Our objective was to describe and compare annual and geographic utilization trends for LDCT screening in the Veteran's Health Administration (VHA).Methods
A national retrospective cohort of screened Veterans from January 1, 2011 to May 31, 2018 was used to calculate annual and regional rates of initial LDCT utilization per 1000 eligible Veterans. We identified Veterans with a first LDCT exam using common procedure terminology codes G0297 or 71250 and described as "lung cancer screening," "screening," or "LCS." The number of screen-eligible Veterans per year was calculated as unique Veterans aged 55 to 80 years seen at a Veterans Affairs medical center (VAMC) in that year, multiplied by 32% (estimated proportion with eligible smoking history). We present 95% confidence intervals (CI) for rates.Results
Screened Veterans had a mean age of 66.1?years (standard deviation [SD] = 5.6); 95.5% male; 77.4% Caucasian. There were 119 300 LDCT exams, of which 80 819 (67.7%) were initial. Nationally, initial screens increased from 0 (95% CI = 0.00 to 0.00) in 2011 to 29.6 (95% CI = 29.26 to 29.88) scans per 1000 eligible Veterans in 2018 (Ptrend < .001). Initial screens increased over time within all geographic regions, most prominently in northeastern and Florida VAMCs.Conclusion
VHA LDCT utilization increased from 2011 to 2018. However, overall utilization remained low. Future interventions are needed to increase lung cancer screening utilization among eligible Veterans.
SUBMITTER: Lewis JA
PROVIDER: S-EPMC7583162 | biostudies-literature | 2020 Oct
REPOSITORIES: biostudies-literature
Lewis Jennifer A JA Samuels Lauren R LR Denton Jason J Edwards Gretchen C GC Matheny Michael E ME Maiga Amelia A Slatore Christopher G CG Grogan Eric E Kim Jane J Sherrier Robert H RH Dittus Robert S RS Massion Pierre P PP Keohane Laura L Nikpay Sayeh S Roumie Christianne L CL
JNCI cancer spectrum 20200613 5
<h4>Background</h4>Many Veterans are high risk for lung cancer. Low-dose computed tomography (LDCT) is an effective strategy for lung cancer early detection in a high-risk population. Our objective was to describe and compare annual and geographic utilization trends for LDCT screening in the Veteran's Health Administration (VHA).<h4>Methods</h4>A national retrospective cohort of screened Veterans from January 1, 2011 to May 31, 2018 was used to calculate annual and regional rates of initial LDCT ...[more]