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J Cancer Treat Res. 2019 Mar;7(1):1-8. doi: 10.11648/j.jctr.20190701.11. Epub 2019 Mar 11.

Examining Lung Cancer Screening Behaviors in the Primary Care Setting: A Mixed Methods Approach.

Journal of cancer treatment and research

Alvie Ahsan, Eva Zimmerman, Elisa Marie Rodriguez, Christy Widman, Deborah Oates Erwin, Frances Georgette Saad-Harfouche, Martin Christopher Mahoney

Affiliations

  1. Jacobs School of Medicine and Biomedical Sciences, State University at New York at Buffalo, Buffalo, USA.
  2. Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, USA.
  3. Department of Internal Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, USA.

PMID: 31179379 PMCID: PMC6554719 DOI: 10.11648/j.jctr.20190701.11

Abstract

While the National Lung Screening Trials (NLST) demonstrated the efficacy of low dose chest computed tomography (LDCT) for lung cancer early detection, utilization of LDCT remains suboptimal. The purpose of this formative study was to understand attitudes and beliefs among primary care clinicians regarding LDCT lung cancer screening as well as to assess gaps in knowledge to identify opportunities for reinforcing personalized lung cancer screening that is accessible and evidence-based. A 20-item closed and open-ended interview was conducted with a targeted group of primary care clinicians (38 respondents; 33 physicians and 5 NPs/PAs). Quantitative data were analyzed using descriptive statistics while qualitative data was analyzed thematically. Although 50.0% of clinicians characterized LDCT as "very effective", only 47.4% of clinicians reported that they frequently or often recommend LDCT as a lung cancer screening tool. Respondents were generally unconcerned with the high rate of false positive test results. The majority of clinicians were referring patients for LDCT based on smoking history, however other factors were also considered (e.g., health status, sex, family history, past medical history, and occupational exposures.) The majority of respondents were knowledgeable about the use of LDCT as a lung screening tool but were unsure about its effectiveness for lung cancer early detection. Some clinicians are recommending patients for LDCT based on factors which are inconsistent with evidence-based guidelines.

Keywords: Clinician Education; Early Detection; Lung Cancer Screening; Primary Care; Provider Perception

Conflict of interest statement

Conflict of Interest The authors declare that they have no conflicts of interest.

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