RetroSearch Browse

Home - News ( United States | United Kingdom | Italy | Germany ) - Football scores

Showing content from https://pubmed.ncbi.nlm.nih.gov/32642161/ below:

Understanding barriers to lung cancer screening in primary care

. 2020 May;12(5):2536-2544. doi: 10.21037/jtd.2020.03.66. Understanding barriers to lung cancer screening in primary care Yanyu Zang², Samantha Terranella¹, Gillian Alex³, Justin Karush^{3 4}, Nicole Geissen^{3 5}, Gary W Chmielewski^{3 6}, Andrew T Arndt³, Michael J Liptay³, Laura J Zimmermann^{7 8}, Linda Dowling³, Ashley Levitan³, Christopher W Seder³

Affiliations

¹ Department of Surgery, Rush University Medical Center, Chicago, IL, USA.
² Bioinformatics and Biostatistics Core, Rush University Medical Center, Chicago, IL, USA.
³ Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, IL, USA.
⁴ Department of Surgery, Rush Copley Medical Center, Aurora, IL, USA.
⁵ Department of Cardiothoracic Surgery, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA.
⁶ Department of Surgery, Northwest Community Hospital, Arlington Heights, IL, USA.
⁷ Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA.
⁸ Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA.

PMID: 32642161
PMCID: PMC7330370
DOI: 10.21037/jtd.2020.03.66

Item in Clipboard

Understanding barriers to lung cancer screening in primary care

Julia M Coughlin et al. J Thorac Dis. 2020 May.

. 2020 May;12(5):2536-2544. doi: 10.21037/jtd.2020.03.66. Authors Julia M Coughlin¹, Yanyu Zang², Samantha Terranella¹, Gillian Alex³, Justin Karush^{3 4}, Nicole Geissen^{3 5}, Gary W Chmielewski^{3 6}, Andrew T Arndt³, Michael J Liptay³, Laura J Zimmermann^{7 8}, Linda Dowling³, Ashley Levitan³, Christopher W Seder³ Affiliations

¹ Department of Surgery, Rush University Medical Center, Chicago, IL, USA.
² Bioinformatics and Biostatistics Core, Rush University Medical Center, Chicago, IL, USA.
³ Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, IL, USA.
⁴ Department of Surgery, Rush Copley Medical Center, Aurora, IL, USA.
⁵ Department of Cardiothoracic Surgery, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA.
⁶ Department of Surgery, Northwest Community Hospital, Arlington Heights, IL, USA.
⁷ Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA.
⁸ Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA.

PMID: 32642161
PMCID: PMC7330370
DOI: 10.21037/jtd.2020.03.66

Item in Clipboard

Abstract

Background: Low-dose computed tomography (LDCT) scan for lung cancer screening is underutilized. Studies suggest that up to one-third of providers do not know the current lung cancer screening guidelines. Thus, identifying the barriers to utilization of LDCT scan is essential.

Methods: Primary care providers in three different healthcare settings in the United States were surveyed to assess provider knowledge of LDCT scan screening criteria, lung cancer screening practices, and barriers to the utilization of LDCT scan screening. Fisher's Exact, Chi-Squared, and Kruskal-Wallis tests were used to compare provider responses. Multivariable logistic regression was used to test the association between provider characteristics and the likelihood of utilizing LDCT scan for lung cancer screening.

Results: The survey was sent to 614 providers, with a 15.7% response rate. Overall, 29.2% of providers report never ordering LDCT scans for eligible patients. Providers practicing at a community or academic hospital more frequently order LDCT scans than those practicing at a safety net hospital. Academic- and community-based providers received a significantly higher mean knowledge score than safety net-based providers [academic 6.84 (SD 1.33), community 6.72 (SD 1.46), safety net 5.85 (SD 1.38); P<0.01]. Overall, only 6.2% of respondents correctly identified all six Centers for Medicare and Medicaid Services eligibility criteria when challenged with three incorrect criteria. Common barriers to utilization of LDCT scan included failure of the electronic medical record (EMR) to notify providers of eligible patients (54.7%), patient refusal (37%), perceived high false-positive rate leading to unnecessary procedures (18.9%), provider time constraints (16.8%), and lack of insurance coverage (13.7%).

Conclusions: Provider knowledge of lung cancer screening guidelines varies, perhaps contributing to underutilization of LDCT scan for lung cancer screening. Improved provider education at safety net hospitals and improving EMR-based best practice alerts may improve the rate of lung cancer screening.

Keywords: CT scan; Lung cancer; screening.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jtd.2020.03.66). CWS serves as an unpaid editorial board member of Journal of Thoracic Disease from Jul 2017 to Jun 2021. The other authors have no conflicts of interest to declare.

Figures
Figure 1

Barriers to the utilization of…

Figure 1

Barriers to the utilization of low dose CT scan. (A) Barriers to the…

Figure 1

Barriers to the utilization of low dose CT scan. (A) Barriers to the utilization of low-dose CT scan; (B) barriers to the utilization of low-dose CT scan continued. USPSTF, United States Preventive Services Task Force; EMR, electronic medical record.