IMPORTANCE The internet is an important source of medical information for many patients and may have a key role in the education of patients about lung cancer screening (LCS). Although most LCS programs in the United States have informational websites, the accuracy, completeness, and readability of these websites have not previously been studied.OBJECTIVE To evaluate the informational content and readability of US LCS program websites. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study assessed US LCS program websites identified on September 15, 2018. A standardized checklist was used to assess key informational content of each website, and text was analyzed for reading level, word count, and reading time. Links to US websites of national advocacy organizations with LCS program content were tabulated. All functional LCS program websites in Google internet search engine results using the search terms lung cancer screening, low-dose CT screening, and lung screening were included in the analysis. MAIN OUTCOMES AND MEASURES Radiologists used a standardized checklist to evaluate content, and readability was assessed with validated scales. Website word count, reading time, and number of links to outside LCS informational websites were assessed. RESULTS A total of 257 LCS websites were included in the analysis. The word count ranged from 73to 4410 (median, 571; interquartile range, 328-909). The reading time ranged from 0.3 to 19.6 minutes (median, 2.5; interquartile range, 1.5-4.0). The median reading level of all websites was grade 10 (interquartile range, 9-11). Only 26% (n = 66) of websites had at least 1 web link to a national website with additional information on LCS. There was wide variability regarding reported eligibility age criteria, with ages 55 to 77 years most frequently cited (42% [n = 108]). Only 56% (n = 143) of websites mentioned smoking cessation. The subject of patient cost was mentioned on 75% (n = 192) of websites. Although major LCS benefits, such as detection of lung cancer, were discussed by most (93% [n = 239]) websites, less than half of the websites (45% [n = 115]) made any mention of possible risks associated with screening.
Objective To investigate the associations of the common MUC5B promoter variant with timing of RA-associated interstitial lung disease (RA-ILD) and RA onset. Methods We identified patients with RA meeting 2010 ACR/EULAR criteria and available genotype information in the Mass General Brigham Biobank, a multi-hospital biospecimen and clinical data collection research study. We determined RA-ILD presence by reviewing all RA patients who had computed tomography (CT) imaging, lung biopsy, or autopsy results. We determined the dates of RA and RA-ILD diagnoses by manual record review. We examined the associations of the MUC5B promoter variant (G > T at rs35705950) with RA-ILD, RA-ILD occurring before or within 2 years of RA diagnosis, and RA diagnosis at age >55 years. We used multivariable logistic regression to estimate odds ratios (OR) for each outcome by MUC5B promoter variant status, adjusting for potential confounders including genetic ancestry and smoking. Results We identified 1,005 RA patients with available genotype data for rs35705950 (mean age 45 years; 79% women; 81% European ancestry). The MUC5B promoter variant was present in 155 (15.4%) and was associated with RA-ILD (multivariable OR 3.34 [95%CI 1.97–5.60]), RA-ILD before or within 2 years of RA diagnosis (OR 4.01 [95%1.78–8.80]), and RA onset after age 55 years (OR 1.52, [95%CI 1.08–2.12]). Conclusions The common MUC5B promoter variant was associated with RA-ILD onset earlier in the RA disease course and older age of RA onset. These findings suggest that MUC5B may impact RA-ILD risk early in the RA disease course, particularly in patients with older-onset RA.
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