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

Lewis, Jennifer A.; Petty, W. Jeffrey; Tooze, Janet A.; Miller, David P.; Chiles, Caroline; Miller, Antonius A.; Weaver, Kathryn E.

doi:10.1016/j.ijrobp.2014.08.034

Cited by 40 publications

(67 citation statements)

References 11 publications

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“…Our finding that SCAFP family physicians lack adequate knowledge of LDCT for lung cancer screening is consistent with recent studies . Hoffman et al found that not all providers were aware of changes in lung cancer screening guidelines.…”

Section: Discussionsupporting

confidence: 92%

“…In this study, we found that a high proportion of physicians believed that LDCT is valuable for the early detection of lung cancer, but a low proportion believed that LDCT reduces lung cancer mortality. This finding is similar to the findings of Lewis et al, who found that less than one‐half of physicians viewed LDCT screening as very or moderately effective in reducing lung cancer mortality. Although we did not ask physicians to compare the efficacy of lung cancer screening with that of other cancer screenings (eg, breast or colon cancer), physicians in Lewis et al's study believed lung cancer screening to be less efficacious than other cancer screenings.…”

Section: Discussionsupporting

confidence: 90%

“…Interestingly, physicians participating in this study were all employed at a single academic medical center that had participated in the NLST. In both aforementioned studies as well as an additional study conducted before the release of the NLST results, physicians believed that lung cancer screening with CXR was appropriate . Although several studies and this study found that physicians still use CXR for lung cancer screening, a small, qualitative study conducted in 2009 revealed that most physicians viewed CXR as outdated and lacking efficacy for lung cancer screening .…”

Section: Discussionmentioning

confidence: 73%

“…Hoffman et al found that not all providers were aware of changes in lung cancer screening guidelines. Similarly, another study reported that almost one‐quarter of physicians did not know any of the screening eligibility components (eg, age eligibility, frequency of screening, or smoking history). Interestingly, physicians participating in this study were all employed at a single academic medical center that had participated in the NLST.…”

Section: Discussionmentioning

confidence: 99%

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Knowledge of, attitudes toward, and use of low‐dose computed tomography for lung cancer screening among family physicians

Ersek

Eberth

McDonnell

et al. 2016

Cancer

118

102

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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.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Knowledge of, attitudes toward, and use of low‐dose computed tomography for lung cancer screening among family physicians

Ersek

Eberth

McDonnell

et al. 2016

Cancer

118

102

View full text Add to dashboard Cite

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“…Not all PCPs are sufficiently familiar with LCS nuances yet to thoroughly counsel patients. 14,29,30 LCS coordinators typically have more time to spend with patients and greater familiarity with the process and trade-offs of LCS, as well as available decision aids, than clinicians who have other competing clinical concerns to address. 17 Empowering coordinators to conduct SDM has helped foster SDM in other LCS programs and is supported by CMS reimbursement policies if the coordinator is a midlevel provider or clinical nurse specialist.…”

Section: Discussionmentioning

confidence: 99%

Patient and Clinician Perspectives on Shared Decision-making in Early Adopting Lung Cancer Screening Programs: a Qualitative Study

et al. 2018

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Smoking cessation and shared decision‐making practices about lung cancer screening among primary care providers

et al. 2021

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Objective We describe primary care providers’ current practice patterns related to smoking cessation counseling and lung cancer screening (LCS). Methods Family, internal medicine, and pulmonary medicine providers from two medical centers were asked to complete an electronic survey to report their practice patterns. Results Of 52 participating providers, most reported initiating three major components of a smoking cessation intervention often or very often: advise to quit (50, 96%), assess willingness to quit (47, 90%), and assist with counseling or pharmacotherapy (49, 94%). However, other components were less commonly initiated such as arranging follow‐ups (only 11 providers indicated recommending them often or very often, 21%) and less than half of providers reported that they often or very often recommend cessation counseling or pharmacotherapy of any type (except varenicline), though family medicine providers were more likely to recommend pharmacotherapy compared to the other specialists (p < 0.01). The majority of providers (47, 92%) reported that they engage in informed/shared decision‐making about LCS, although only about one‐third (17, 33%) indicated using a patient decision aid. Pulmonary medicine providers were more likely to use decision aids than providers from internal or family medicine (p < 0.04). Conclusions Within the context of LCS, primary care providers report often having conversations about smoking cessation with their patients who smoke, have no clear preference for type of treatment, and rarely use follow‐up calls or visits pertaining to quitting smoking. While many providers report engaging in shared decision‐making about LCS, few use a decision aid for this conversation.

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

Cited by 40 publications

References 11 publications

Knowledge of, attitudes toward, and use of low‐dose computed tomography for lung cancer screening among family physicians

Knowledge of, attitudes toward, and use of low‐dose computed tomography for lung cancer screening among family physicians

Patient and Clinician Perspectives on Shared Decision-making in Early Adopting Lung Cancer Screening Programs: a Qualitative Study

Smoking cessation and shared decision‐making practices about lung cancer screening among primary care providers

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