Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Individuals undergoing lung cancer screening (LCS) have a high comorbidity burden, yet the extent and impact of frailty are unknown. We sought to characterize the predicted probability of frailty and comorbidity burden among individuals undergoing LCS and compare screening results and downstream healthcare utilization in those with less versus more frailty and comorbidity. METHODS: This cohort study linked North Carolina Lung Screening Registry data with Medicare, Medicaid, and private payer insurance claims from individuals undergoing baseline LCS between 2013 and 2020. We evaluated the predicted probability of frailty using the Faurot frailty index (FFI) and comorbidity using the Charlson comorbidity score (CCS). We compared LCS imaging results by FFI and CCS and rates of downstream imaging and invasive procedures by FFI and CCS using χ2 tests. RESULTS: Among 3,923 individuals screened, 82.1% had low FFI, and 55% had CCS < 2. CCS was higher among those with higher FFI (P < 0.0001). LCS results did not differ based on FFI or CCS. In individuals with a negative LCS result, downstream imaging rates per 100 persons were higher among persons with greater than low versus low FFI [22.3%, 95% confidence interval (CI), 18.8-25.8 vs. 16.1%, 95% CI, 14.7-17.6, respectively] and among those with CCS ≥ 2 versus CCS < 2 [20.2%, 95% CI, 18.2-22.3 vs. 14.8%, 95% CI, 13.1-16.5, respectively]. CONCLUSIONS: Individuals undergoing LCS have a similar frailty burden to the general older adult population. More versus less frail individuals had a higher comorbidity burden. IMPACT: Our novel finding that the majority of screened individuals had a low predicted probability of frailty provides some reassurance that few individuals with screen-detected lung cancer may be unable to undergo treatment based on frailty criteria.
Language: English
Topic: Frailty in Older Adults
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Funders: Magyar Agrár- és Élettudományi Egyetem, National Foundation for Cancer Research, Fondazione CRT, Familjen Erling-Perssons Stiftelse, Fondation Brain Canada, Intuitive Surgical, Stiftelsen för Gamla Tjänarinnor, Weston Brain Institute, UK Research and Innovation, Australian Government, GHR Foundation, Barts Charity, Chengdu Medical College, Department of Science and Technology, Ministry of Science and Technology, India, Deutsche Forschungsgemeinschaft, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, Fundação de Amparo à Pesquisa do Estado de São Paulo, National Natural Science Foundation of China, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Chinese Academy of Sciences, Imam Mohammed Ibn Saud Islamic University, Universidad Nacional de Colombia, China Postdoctoral Science Foundation, China National Petroleum Corporation, Nederlandse Organisatie voor Wetenschappelijk Onderzoek, Lunds Universitet, Generalitat Valenciana, Ministero dell’Istruzione, dell’Università e della Ricerca, Natural Science Foundation of Fujian Province, Science and Technology Commission of Shanghai Municipality, Conselho Nacional de Desenvolvimento Científico e Tecnológico, National Research Foundation of Korea, Natural Science Foundation of Hebei Province, Israel Science Foundation, Knut och Alice Wallenbergs Stiftelse, Princess Nourah Bint Abdulrahman University, Vetenskapsrådet, Fondazione Umberto Veronesi, University of Tokyo, Göteborgs Universitet, Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse, Natural Science Foundation of Shandong Province, Svenska Läkaresällskapet, China National Tobacco Corporation, Morinaga Foundation For Health and Nutrition, Science and Technology Commission of Putuo District, Hunan Tobacco Company, BC Cancer Foundation, UK Dementia Research Institute, RUDN University, Olav Thon Stiftelsen, National Institutes of Health, Centers for Disease Control and Prevention, Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, Australian Research Council, Japan Society for the Promotion of Science, Japan Science and Technology Agency, National Key Research and Development Program of China, Fundamental Research Funds for the Central Universities, Agricultural Science and Technology Innovation Program, Basic and Applied Basic Research Foundation of Guangdong Province, National Cancer Institute, National Institute of General Medical Sciences, National Center for Advancing Translational Sciences, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, NHLBI Division of Intramural Research, Yirgalem Hospital Medical College, Universidad CEU Cardenal Herrera
OpenAlex ID: W4416422180