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Knowledge of, attitudes toward, and use of low‐dose computed tomography for lung cancer screening among family physicians
Author(s) -
Ersek Jennifer L.,
Eberth Jan M.,
McDonnell Karen Kane,
Strayer Scott M.,
Sercy Erica,
Cartmell Kathleen B.,
Friedman Daniela B.
Publication year - 2016
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.29944
Subject(s) - medicine , lung cancer screening , family medicine , medicaid , reimbursement , lung cancer , outreach , emergency medicine , health care , political science , law , economics , economic growth
BACKGROUND The results of the National Lung Screening Trial showed a 20% reduction in lung cancer mortality and a 6.7% reduction in all‐cause mortality when high‐risk patients were screened with low‐dose computed tomography (LDCT) versus chest x‐ray (CXR). The US Preventive Services Task Force has issued a grade B recommendation for LDCT screening, and the Centers for Medicare and Medicaid Services and private insurers now cover the screening cost under certain conditions. The purpose of this study was to assess the knowledge of, attitudes toward, and use of LDCT screening for lung cancer among family physicians. METHODS A 32‐item questionnaire was distributed to members of the South Carolina Academy of Family Physicians in 2015. Descriptive statistics were calculated. RESULTS There were 101 respondents, and most had incorrect knowledge about which organizations recommended screening. Many physicians continued to recommend CXR for lung cancer screening. Most felt that LDCT screening increased the odds of detecting disease at earlier stages (98%) and that the benefits outweighed the harms (75%). Concerns included unnecessary procedures (88%), stress/anxiety (52%), and radiation exposure (50%). Most physicians discussed the risks/benefits of screening with their patients in some capacity (76%); however, more than 50% reported making 1 or no screening recommendations in the past year. CONCLUSIONS Most family physicians report discussing LDCT with patients at high risk for lung cancer; however, referrals remain low. There are gaps in physician knowledge about screening guidelines and reimbursement, and this indicates a need for further educational outreach. The development of decision aids may facilitate shared decision‐making discussions about screening, and targeted interventions may improve knowledge gaps. Cancer 2016;122:2324–2331 . © 2016 American Cancer Society .