ObjectivePrior to the 2013 US Preventive Services Task Force (USPSTF) guidelines for lung cancer screening, the American Cancer Society released interim guidance recommending physicians discuss lung cancer screening with high risk patients. We included a question on patient–provider discussions about lung cancer screening on a statewide population-based survey to establish baseline prevalence for surveillance and to identify subpopulation disparities.MethodsWe analyzed the 2012/2013 Kansas Adult Tobacco Survey to assess patient–provider discussions about lung cancer screening. Weighted prevalence estimates and adjusted odds ratios were calculated to examine characteristics associated with discussing screening.ResultsThe prevalence of patient–provider discussions about lung cancer screening among current and former smokers aged 55 to 74 years was 31.0% (95% CI 27.0–35.0). The adjusted prevalence odds of having these discussions was higher among males, adults aged 65 to 74 years, adults living with a disability, as well as those who saw a health professional in the past year and had their smoking status assessed or were advised to quit.ConclusionsThe current study is unique as it is the first to assess patient–provider discussions about lung cancer screening using a statewide survey. These results may inform strategies to increase patient–provider discussions about lung cancer screening among high risk Kansans.
BACKGROUND: Breast cancer disparities by disability status are poorly understood. While previous studies have shown increased odds of late stage at diagnosis, it is unclear whether the incidence of breast cancer varies by disability status. METHODS: To assess cancer incidence and stage at diagnosis among disabled and nondisabled Medicare beneficiaries in Kansas, a retrospective cohort study was conducted using linked Medicare enrollment and Kansas Cancer Registry data from 2007 to 2009. Disability status was determined by the indicator for the original reason for Medicare eligibility. RESULTS: Among the 651,337 Medicare beneficiaries included in the cohort, there were 2,384 cases of breast cancer. The age-adjusted incidence was 313 per 100,000 among female beneficiaries with disabilities and 369 per 100,000 among nondisabled female beneficiaries. The adjusted incidence rate ratio was 0.93 (95% CI 0.73-1.18). When assessing stage at diagnosis, there was no difference in the odds of late stage at diagnosis by disability status (OR = 1.02; 95% CI 0.68-1.50). CONCLUSION: No significant difference in incidence or stage at diagnosis was identified among this cohort. The use of Medicare eligibility to define disability status presented a number of limitations. Future studies should seek alternate definitions of disability to assess disparities in breast cancer incidence, including definitions using Medicare claims data.
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