Impact of Mass Screening Using Chest X-Ray on Mortality Reduction and Treatment Adherence Among Pulmonary Tuberculosis Patients
10.3346/jkms.2024.39.e286
- Author:
Ji Yoon BAEK
1
;
Sayada Zartasha KAZMI
;
Hyunmin LEE
;
Yerin HWANG
;
So Jin PARK
;
Myung-Hee SHIN
;
Jayoun LEE
;
Hongjo CHOI
;
Aesun SHIN
Author Information
1. Cancer Research Institute, Seoul National University, Seoul, Korea
- Publication Type:Original Article
- From:Journal of Korean Medical Science
2024;39(45):e286-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Evaluate the impact of chest X-ray (CXR) screening on mortality and treatment adherence by comparing pulmonary tuberculosis (PTB) cases detected through screening and those routinely diagnosed at healthcare facilities.
Methods:A retrospective analysis of 10% randomly sampled National Health Insurance Service claims data assessed PTB cases diagnosed during 2004–2020. Patients were categorized as ‘screening-detected (ACF, active case finding)’ or ‘routinely detected (PCF, passive case finding)’ based on CXR screening history. Cox proportional hazards model determined the association between screening and all-cause or tuberculosis (TB)-specific mortality. Treatment adherence was also measured.
Results:Among 84,828 PTB patients, 18.76% were ACF (15,916), and 81.24% were PCF (68,912). ACF exhibited lower risks in all-cause mortality (adjusted hazard ratio [aHR], 0.70;95% confidence interval [CI], 0.67–0.73) and TB-specific mortality (aHR, 0.38; 95% CI, 0.32–0.46) compared to PCF. In the ACF group, 91.39% initiated anti-TB treatment, with 45.99% adherence. For PCF, 92.87% initiated treatment, and only 45.44% were adherent.
Conclusion:Individuals undergoing CXR screening have a lower risk of both all-cause and TB-specific mortality compared to PCF, but treatment adherence is similar between the two groups, emphasizing the need to improve the linkage between screening, diagnosis, and treatment for the screened population.
