肺癌高危人群低剂量螺旋CT筛查依从性影响因素的Meta分析-现代医学

肺癌高危人群低剂量螺旋CT筛查依从性影响因素的Meta分析

单位：南京医科大学护理学院, 江苏南京 211166

分类号：R473.74

出版年·卷·期（页码）：2025·53·第七期（1080-1088）

摘要：

目的：系统评价肺癌高危人群低剂量螺旋CT筛查依从性影响因素，为后续制定提高肺癌高危人群筛查依从性的干预措施提供依据。方法：计算机检索中国知网(CNKI)、万方(Wangfang)、中文生物医学文献数据库(CBM)、维普数据库(VIP)、PubMed、Web of Science、Embase、CINAHL、Cochrane Library数据库，获取有关肺癌高危人群低剂量螺旋CT筛查依从性影响因素的相关文献。检索时间为建库至2024年8月。使用Stata 17.0软件进行Meta分析。结果：共纳入14项研究，总样本量为172 047例，其中依从人数共67 573例。Meta分析结果显示，肺癌高危人群筛查依从率为36%，女性(OR=1.30，95%CI 1.25~1.35)、年龄处于 50~59 岁(OR=1.10，95%CI 1.07~1.13)、文化程度较高(OR=1.10，95%CI 1.07~1.13)、有肺癌家族史(OR=1.72，95%CI 1.11~2.68)、有慢性呼吸系统疾病史(OR=1.92，95%CI 1.84~2.01)、被动吸烟(OR=1.40，95%CI 1.29~1.52)是肺癌筛查依从性的保护因素；吸烟(OR=0.82，95%CI 0.79~0.84)、饮酒(OR=0.86，95%CI 0.83~0.89)、体育运动(OR=0.81，95%CI 0.79~0.84)是肺癌筛查依从性的危险因素。敏感性分析结果显示，Meta 分析结果相对稳定。漏斗图提示纳入文献存在一定的发表偏倚。结论：肺癌高危人群低剂量螺旋CT筛查依从性受到人口学、生活方式、健康史、环境因素影响。因此，医务人员在开展肺癌高危人群筛查时，可根据相关影响因素制定个性化干预措施。

Objective:To systematically evaluate the factors influencing the adherence to low-dose spiral CT screening among high-risk groups for lung cancer, and to provide a basis for the subsequent development of interventions to improve the adherence to screening among high-risk groups for lung cancer.Methods: A computerized search was conducted on China National Knowledge Infrastructure(CNKI ), Wanfang, Chinese Biomedical Literature Database(CBM), China Science and Technology Journal Database(VIP), PubMed, Web of Science, Embase, CINAHL, and Cochrane Library to obtain relevant literature on the factors influencing the adherence to low-dose spiral CT screening among high-risk groups for lung cancer. The searching period was from the establishment of the database to August 2024. Meta-analysis was performed using Stata 17.0 software. Results:A total of 14 studies were included, with a total sample size of 172 047, of which the number of adherents totaled 67 573 cases. Meta-analysis showed that the adherence rate of screening among people at high risk for lung cancer was 36%, and that women(OR=1.30, 95%CI 1.25-1.35), with an age ranging 50-59 years(OR=1.10, 95%CI 1.07-1.13), higher education(OR=1.10, 95%CI 1.07-1.13), family history of lung cancer(OR=1.72, 95%CI 1.11-2.68),chronic respiratory disease history(OR=1.92, 95%CI 1.84-2.01) and passive smoking(OR=1.40, 95%CI 1.29-1.52) were protective factors for adherence to lung cancer screening; smoking(OR=0.82, 95%CI 0.79-0.84),alcohol consumption(OR=0.86, 95%CI 0.83-0.89), and physical activity(OR=0.81, 95%CI 0.79-0.84) were risk factors for adherence to lung cancer screening. The results of sensitivity analyses showed that the results of Meta-analysis were relatively stable. The funnel plot suggested there was some publication bias in the included literature. Conclusion: Adherence to low-dose spiral CT screening in lung cancer risk groups is influenced by demographic, lifestyle, health history, and environmental factors. Therefore, medical professionals can develop personalized interventions based on relevant influencing factors when conducting screening for high-risk groups for lung cancer.

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