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Showing content from http://www.ncbi.nlm.nih.gov/pubmed/25613118 below:

Low-Dose CT Lung Cancer Screening Practices and Attitudes among Primary Care Providers at an Academic Medical Center

Affiliations

• ¹ Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
• ² Department of Internal Medicine, Section on Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
• ³ Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
• ⁴ Department of Radiology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
• ⁵ Department of Internal Medicine, Section on Pulmonology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
• ⁶ Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina. keweaver@wakehealth.edu.

• PMID: 25613118
• PMCID: PMC4383689
• DOI: 10.1158/1055-9965.EPI-14-1241

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Jennifer A Lewis et al. Cancer Epidemiol Biomarkers Prev. 2015 Apr.

• ¹ Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
• ² Department of Internal Medicine, Section on Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
• ³ Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
• ⁴ Department of Radiology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
• ⁵ Department of Internal Medicine, Section on Pulmonology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
• ⁶ Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina. keweaver@wakehealth.edu.

• PMID: 25613118
• PMCID: PMC4383689
• DOI: 10.1158/1055-9965.EPI-14-1241

Item in Clipboard

Background: Low-dose computed tomography (LDCT) screening reduces lung cancer-specific and overall mortality. We sought to assess lung cancer screening practices and attitudes among primary care providers (PCPs) in the era of new LDCT screening guidelines.

Methods: In 2013, we surveyed PCPs at an academic medical center (60% response) and assessed: lung cancer screening use, perceived screening effectiveness, knowledge of screening guidelines, perceived barriers to LDCT use, and interest in LDCT screening education.

Results: Few PCPs (n = 212) reported ordering lung cancer screening: chest X-ray (21%), LDCT (12%), and sputum cytology (3%). Only 47% of providers knew three or more of six guideline components for LDCT screening; 24% did not know any guideline components. In multiple logistic regression analysis, providers who knew three or more guideline components were more likely to order LDCT (OR, 7.1; 95% confidence intervals, 2.0-25.6). Many providers (30%) were unsure of the effectiveness of LDCT. Mammography, colonoscopy, and Pap smear were rated more frequently as effective in reducing cancer mortality compared with LDCT (all P values < 0.0001). Common perceived barriers included patient cost (86.9% major or minor barrier), harm from false positives (82.7%), patients' lack of awareness (81.3%), risk of incidental findings (81.3%), and insurance coverage (80.1%).

Conclusions: LDCT lung cancer screening is currently an uncommon practice at an academic medical center. PCPs report ordering chest X-ray, a nonrecommended screening test, more often than LDCT. PCPs had a limited understanding of lung cancer screening guidelines and LDCT effectiveness. Provider educational interventions are needed to facilitate shared decision-making with patients.

Impact: This study describes some of the first data available about PCPs' use of lung cancer screening tests since the publication of multiple professional guidelines endorsing LDCT. Knowledge gaps were identified that may hinder the uptake of evidence-based lung cancer screening guidelines.

©2015 American Association for Cancer Research.

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Reported Use of Lung Cancer…

Reported Use of Lung Cancer Screening Modalities in the Past Year Among Primary…

Reported Use of Lung Cancer Screening Modalities in the Past Year Among Primary Care Providers in an Academic Medical Center (N= 212) by Guideline Knowledge. Bars indicate upper 95% confidence interval for the estimate. CXR= Chest x-ray, LDCT= Low-dose computed tomography

Primary Care Providers’(N=212) Perceived Major…

Primary Care Providers’(N=212) Perceived Major and Minor Barriers to Lung Cancer Screening with…

Primary Care Providers’(N=212) Perceived Major and Minor Barriers to Lung Cancer Screening with Low-Dose Chest CT.

• Opinions and Practices of Lung Cancer Screening by Physician Specialty.

  Henderson LM, Marsh MW, Benefield TS, Jones LM, Reuland DS, Brenner AT, Goldstein AO, Molina PL, Maygarden SJ, Rivera MP. Henderson LM, et al. N C Med J. 2019 Jan-Feb;80(1):19-26. doi: 10.18043/ncm.80.1.19. N C Med J. 2019. PMID: 30622199 Free PMC article.

• High-risk community and primary care providers knowledge about and barriers to low-dose computed topography lung cancer screening.

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• Attitudes About Lung Cancer Screening: Primary Care Providers Versus Specialists.

  Rajupet S, Doshi D, Wisnivesky JP, Lin JJ. Rajupet S, et al. Clin Lung Cancer. 2017 Nov;18(6):e417-e423. doi: 10.1016/j.cllc.2017.05.003. Epub 2017 May 10. Clin Lung Cancer. 2017. PMID: 28648531 Free PMC article.

• Lung Cancer Screening: Computed Tomography Radiation and Protocols.

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• A meta-analysis: is low-dose computed tomography a superior method for risky lung cancers screening population?

  Fu C, Liu Z, Zhu F, Li S, Jiang L. Fu C, et al. Clin Respir J. 2016 May;10(3):333-41. doi: 10.1111/crj.12222. Epub 2014 Nov 26. Clin Respir J. 2016. PMID: 25307063 Review.

• Opinions and Practices of Lung Cancer Screening by Physician Specialty.

  Henderson LM, Marsh MW, Benefield TS, Jones LM, Reuland DS, Brenner AT, Goldstein AO, Molina PL, Maygarden SJ, Rivera MP. Henderson LM, et al. N C Med J. 2019 Jan-Feb;80(1):19-26. doi: 10.18043/ncm.80.1.19. N C Med J. 2019. PMID: 30622199 Free PMC article.

• Evaluating Potential Racial Inequities in Low-dose Computed Tomography Screening for Lung Cancer.

  Richmond J, Mbah OM, Dard SZ, Jordan LC, Cools KS, Samuel CA, Khan JM, Manning MA. Richmond J, et al. J Natl Med Assoc. 2020 Apr;112(2):209-214. doi: 10.1016/j.jnma.2019.10.002. Epub 2020 Feb 15. J Natl Med Assoc. 2020. PMID: 32067762 Free PMC article.

• Lung Cancer Screening Knowledge, Attitudes, and Practice Patterns Among Primary and Pulmonary Care Clinicians.

  Carter-Bawa L, Walsh LE, Schofield E, Williamson TJ, Hamann HA, Ostroff JS. Carter-Bawa L, et al. Nurs Res. 2023 Jan-Feb 01;72(1):3-11. doi: 10.1097/NNR.0000000000000629. Epub 2022 Oct 16. Nurs Res. 2023. PMID: 36260526 Free PMC article.

• Targeted Incentive Programs For Lung Cancer Screening Can Improve Population Health And Economic Efficiency.

  Kim DD, Cohen JT, Wong JB, Mohit B, Fendrick AM, Kent DM, Neumann PJ. Kim DD, et al. Health Aff (Millwood). 2019 Jan;38(1):60-67. doi: 10.1377/hlthaff.2018.05148. Health Aff (Millwood). 2019. PMID: 30615528 Free PMC article.

• Health beliefs toward lung cancer screening among Chinese American high-risk smokers: Interviews based on Health Belief Model.

  Lei F, Chen WT, Brecht ML, Zhang ZF, Lee E. Lei F, et al. Int J Nurs Sci. 2022 Jun 23;9(3):378-388. doi: 10.1016/j.ijnss.2022.06.005. eCollection 2022 Jul. Int J Nurs Sci. 2022. PMID: 35891915 Free PMC article.

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