Abstract:
BACKGROUND:Low-dose CT scan reduces lung cancer mortality in high-risk patients fit to undergo surgical resection. Racial disparities in resection of lung cancer in nonscreening populations are well described. We describe surgical resection patterns of patients with early stage non-small cell lung cancer (NSCLC) in the National Lung Screening Trial (NLST) and examine whether racial disparities exist among blacks. METHODS:We identified all NLST participants with clinical stage I NSCLC. Covariates included demographics, smoking history, comorbidities, tumor characteristics, and timing of cancer detection. Using logistic regression, we assessed resection rates of blacks vs whites. RESULTS:Among 752 patients with clinical stage I disease, 692 patients (92%) underwent resection. Unadjusted surgical resection rates for white men, white women, black men, and black women were 92%, 91%, 61%, and 90%, respectively. In adjusted analyses, compared with white men, black men had a 28% lower risk (relative risk, 0.72; 95% CI, 0.50-0.99) of undergoing surgery; however, white women and black women underwent surgery at comparable rates as white men. The odds of undergoing limited resection instead of full resection were 70% greater in white women than white men (OR, 1.69; 95% CI, 1.08-2.65). CONCLUSIONS:Our study shows that disparities in the surgical treatment of lung cancer persist, even among NLST participants who were considered fit to undergo thoracic surgery. As lung cancer screening disseminates into clinical practice, efforts targeting black men should be prioritized.
journal_name
Chestjournal_title
Chestauthors
Balekian AA,Wisnivesky JP,Gould MKdoi
10.1016/j.chest.2018.07.011subject
Has Abstractpub_date
2019-01-01 00:00:00pages
44-52issue
1eissn
0012-3692issn
1931-3543pii
S0012-3692(18)31078-Xjournal_volume
155pub_type
杂志文章,多中心研究,随机对照试验相关文献
CHEST文献大全abstract::To examine whether changes in respiratory chemosensitivity during the menstrual cycle are related to worsening of airway functions, hypoxic and hypercapnic ventilatory and P0.1 responses, airway function, and serum progesterone levels were studied in 11 female asthmatic patients in both the follicular and luteal phase...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.104.6.1718
更新日期:1993-12-01 00:00:00
abstract::Nineteen patients were treated at the Los Angeles County Harbor/UCLA Medical Center between 1971 and 1986 for tuberculosis of the spine. Fourteen were immigrants, a high-risk group. A high index of suspicion is required for Pott's disease, which occurs in fewer than 1 percent of patients with tuberculosis, often prese...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.95.1.145
更新日期:1989-01-01 00:00:00
abstract::A 60-year-old man developed histologic lesions characteristic of acute febrile neutrophilic dermatosis in skin and lung during preleukemic and leukemic phases of acute myeloid leukemia. These lesions showed improvement and resolution during oral prednisone therapy, requiring higher doses during each relapse. The respo...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.90.6.922
更新日期:1986-12-01 00:00:00
abstract::Pulmonary specimens obtained from ten normal subjects and 53 patients with various pulmonary diseases were studied with energy-dispersive x-ray analysis. The amount of silicon in the pulmonary tissue was determined and expressed as a silicon/sulfur (Si/S) ratio. This Si/S ratio was below 0.2 in the ten normal subjects...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.85.4.506
更新日期:1984-04-01 00:00:00
abstract:STUDY OBJECTIVES:To determine whether the nuclear accumulation of p53 in patients with early bronchial neoplasia represents an altered susceptibility for the development of lung cancer. PATIENTS AND MEASUREMENTS:We evaluated the percentage of cells accumulating nuclear p53 immunohistochemically in squamous cell carcin...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.123.1.181
更新日期:2003-01-01 00:00:00
abstract:STUDY OBJECTIVES:To describe four patients having total anomalous pulmonary venous connection with an intrapulmonary vertical vein, rendering difficulty in diagnosis and surgery. SETTING:a tertiary referral center. PATIENTS AND METHODS:By reviewing medical records, 4 of 25 patients with right atrial isomerism and tot...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.110.5.1363
更新日期:1996-11-01 00:00:00
abstract:STUDY OBJECTIVES:To examine the effect of patient body mass index (BMI) on outcome in intensive care. DESIGN:In a prospective study, the patients were classified into groups based on the calculated BMI, as follows: BMI < 19.0 (n = 350), > or = 19.0 and < 25.0 (n = 663), > or = 25.0 and < 29.9 (n = 585), > or = 30.0 an...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.127.6.2125
更新日期:2005-06-01 00:00:00
abstract:STUDY OBJECTIVES:Among adults presenting to the emergency department (ED) with acute asthma, we sought to determine the prevalence of obesity, and the relation of body mass index (BMI) to asthma severity in this high-risk population. DESIGN:Multicenter, prospective cohort study. SETTING:Twenty-six North American EDs....
journal_title:Chest
pub_type: 杂志文章,多中心研究
doi:10.1378/chest.124.3.795
更新日期:2003-09-01 00:00:00
abstract:STUDY OBJECTIVES:Evidence exists that HIV-seropositive individuals may be at increased risk for the development of precocious pulmonary emphysema. HIV infection is also associated with antioxidant deficiency in both the serum and lungs, and it is therefore possible that increased oxidant stress may contribute to parenc...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.126.5.1439
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Pulmonary aspiration is an important recognized cause of ARDS. Better characterization of patients who aspirate may allow identification of potential risks for aspiration that could be used in future studies to mitigate the occurrence of aspiration and its devastating complications. METHODS:We conducted a s...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.13-3028
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Pulmonary arterial hypertension (PAH) is a progressive disease with high rates of morbidity and mortality. Current therapies improve symptoms, functional capacity, and, in select cases, survival. Little is known about patient factors that may predict the likelihood of patient-important, clinically relevant r...
journal_title:Chest
pub_type: 杂志文章,随机对照试验
doi:10.1378/chest.14-0263
更新日期:2015-01-01 00:00:00
abstract::Studies using epicardial mapping on patients with Wolff-Parkinson-White syndrome have demonstrated that the delta vector of the electrocardiogram is a detector of the location of at least one bypass tract. In order to relate the electrical activities (preexcitation) with the mechanical activity (septal and ventricular...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.71.4.463
更新日期:1977-04-01 00:00:00
abstract:BACKGROUND:Pleural effusions frequently accumulate in patients with left-sided heart failure. However, our recent study in patients with idiopathic and heritable pulmonary arterial hypertension (PAH) demonstrated that pleural effusions frequently occur in patients with isolated right-sided heart failure (RHF). The obje...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.10-0227
更新日期:2011-07-01 00:00:00
abstract:STUDY OBJECTIVES:To determine the incidence and mortality as well as to analyze the clinical and pathologic changes of aortic dissection. DESIGN AND SETTING:A population-based longitudinal study over 27 years on a study population of 106,500, including 66 hospitalized and 18 nonhospitalized consecutively observed pati...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.117.5.1271
更新日期:2000-05-01 00:00:00
abstract::Macrophages are the most abundant immune cell population in normal lung tissue and serve critical roles in innate and adaptive immune responses as well as the development of inflammatory airway disease. Studies in a mouse model of chronic obstructive lung disease and translational studies of humans with asthma and COP...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.10-2132
更新日期:2011-09-01 00:00:00
abstract::Benign thymic hyperplasia (BTH) is a known feature of hyperthyroidism, but is infrequently appreciated by clinicians. In most cases thymic enlargement is minimal; however, it may occasionally present as an appreciable anterior mediastinal mass. While surgical resection is a common approach to such a mass, recognition ...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.90.5.691
更新日期:1986-11-01 00:00:00
abstract::An 80-year-old man presented because of superficial head trauma sustained after falling from bed. On review of systems, he reported worsening dyspnea on exertion, nonproductive cough, and weight loss over the preceding 2 to 3 months. There was no report of chest pain or leg swelling. He had a past medical history of h...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2015.12.023
更新日期:2016-05-01 00:00:00
abstract::Nocturnal noninvasive ventilation (NNV), the provision of ventilatory assistance via a noninvasive interface mainly during sleep, has assumed an important role in the management of chronic hypoventilatory syndromes. This review focuses on recent developments related to the use of NNV to treat various forms of chronic ...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.07-1527
更新日期:2008-05-01 00:00:00
abstract::There is a small population of peripheral T cells bearing the gamma delta T-cell receptor, which may be involved in the defense against invading microorganisms and tumor cells. The present study was designed to evaluate the levels of gamma delta T cells in patients with pulmonary tuberculosis, bacterial pneumonia, chr...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.102.1.195
更新日期:1992-07-01 00:00:00
abstract:STUDY OBJECTIVES:COPD patients run a risk of developing nocturnal oxygen desaturation. When evaluating patients with nocturnal hypoxemia, an unfamiliar hospital environment and the monitoring equipment may cause sleep disturbances. It was hypothesized that increased sleep disruption will lead to fewer instances of desa...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.119.6.1820
更新日期:2001-06-01 00:00:00
abstract::This chapter about the recognition, treatment, and prevention of heparin-induced thrombocytopenia (HIT) is part of the Antithrombotic and Thrombolytic Therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Grade 1 recommendations are strong and indicate that the benefi...
journal_title:Chest
pub_type: 杂志文章,实务指引
doi:10.1378/chest.08-0677
更新日期:2008-06-01 00:00:00
abstract::The spontaneous variability of arterial blood gas and pH values (ABGs) was examined in a group of 28 typical stable medical ICU patients under a variety of ventilatory conditions. In each patient, 13 ABG specimens were measured at 5-min intervals during a 1-h study period using a new bedside, extravascular fluorescent...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.106.1.187
更新日期:1994-07-01 00:00:00
abstract:STUDY OBJECTIVES:We sought to compare arterial oxygen partial pressure (PaO2) relationships between a 15.1% hypoxia inhalation test (HIT) at sea level and a hypobaric chamber exposure equivalent to 2,438 m (8,000 feet) of altitude above sea level in patients with chronic obstructive pulmonary disease (COPD) and healthy...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.107.2.352
更新日期:1995-02-01 00:00:00
abstract:BACKGROUND:The objective of this study was to systematically review and quantitatively synthesize all randomized controlled trials (RCTs), comparing important outcomes in ventilated critically ill patients who received an early or late tracheotomy. METHODS:A systematic literature search of PubMed, Cumulative Index to ...
journal_title:Chest
pub_type: 杂志文章,meta分析,评审
doi:10.1378/chest.11-2024
更新日期:2011-12-01 00:00:00
abstract:STUDY OBJECTIVES:Hyperinflation in patients with severe COPD is associated with an increased anteroposterior (AP) rib cage diameter. We sought to determine whether bilateral lung volume reduction surgery (LVRS) affects bony thorax configuration. DESIGN:Prospective of clinical data collection before and after LVRS. SE...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.116.1.30
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:Pulmonary hypertension (PH) is a common complication of sarcoidosis that is associated with increased mortality. The pathogenesis of PH in sarcoidosis is uncertain, and the role of pulmonary arterial hypertension (PAH)-specific therapies remains to be determined. METHODS:We conducted a retrospective study o...
journal_title:Chest
pub_type: 杂志文章,多中心研究
doi:10.1378/chest.08-1881
更新日期:2009-06-01 00:00:00
abstract::Systolic ejection clicks, often associated with cardiac disease, can be distinguished from mid-systolic clicks of mitral and tricuspid origin, which are frequently benign. A different mid-systolic sound has been recognized, with timing similar to the mid-systolic clicks, which is associated with aortic insufficiency. ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.83.1.141
更新日期:1983-01-01 00:00:00
abstract::A 41-year-old woman with end-stage mitral and aortic stenosis developed the cycle of low cardiac output, peripheral vasoconstriction, increased core temperature, and cardiac decompensation. This was interrupted by core cooling utilizing iced gastric lavage. We propose that her severe hyperthermia was caused or abetted...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.72.1.107
更新日期:1977-07-01 00:00:00
abstract::Eighteen postmenopausal women were examined by Doppler echocardiography before initiation of HRT (T1), then after ten weeks (T2) and one year (T3). This study group was compared with another in which HRT was not used. Flow velocity integral, which correlates with SV, and MA, an indicator of cardiac contractility, were...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.102.5.1496
更新日期:1992-11-01 00:00:00
abstract::Numerous alterations in the sympathetic nervous system have been reported in patients with obstructive sleep apnea. It is unclear whether such alterations can be attributed to the respiratory disturbance itself, the resulting hypoxia, or disruption of sleep. We examined urinary norepinephrine levels in 45 individuals ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.111.3.639
更新日期:1997-03-01 00:00:00