Teleconsultation for Delivering Low-Dose Computed Tomography Reports in a Mobile Lung Cancer Screening Program in a Low- and Middle-Income Country: A Cross-Sectional Study

在低收入和中等收入国家开展的移动肺癌筛查项目中,利用远程会诊提供低剂量计算机断层扫描报告:一项横断面研究

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Abstract

IntroductionLung cancer is the leading cause of cancer-related death. Screening for lung cancer using low dose computed tomography (LDCT) significantly reduces lung cancer mortality. However, their implementations must be cost-effective while also prioritizing inclusivity and equity. In this context, telemedicine has emerged as a strategy to reduce costs and enhance access to specialized healthcare. This study aims to describe a Brazilian experience with teleconsultation for delivering LDCT reports, its impact on smoking cessation counseling, and the factors influencing participants' enrollment in the Barretos Cancer Hospital Lung Cancer Screening Program (BCH-LCSP).MethodsThis cross-sectional analysis was conducted within the BCH-LCSP cohort and describes the teleconsultation process implemented as part of the program. Differences in sociodemographic characteristics between participants who received LDCT results through in-person consultations vs teleconsultations were examined using t-test or chi-square test.ResultsOf 793 enrolled participants, 747 (94.2%) received reports via teleconsultation and 46 (5.8%) in person. Teleconsultations were more likely to be used by females (53%). Of the 793 participants, 559 were current smokers. Among those 559, 152 participated in the smoking cessation intervention for at least 1 year, and 26 (17.1%) of them successfully quit smoking. Participants' motivations to enroll in the LCS included prevention, smoking-related concerns, as well as general health concerns, and desire to quit smoking.ConclusionTeleconsultation shows potential as a practical approach for LDCT delivery and smoking cessation counseling in Brazil, providing a scalable model that could improve access and equity in lung cancer screening programs in low and middle-income countries and globally.

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