Primary care providers’ views on a future lung cancer screening program

Abstract

Background The National Lung Screening Trial demonstrated that screening with low-dose computed tomography significantly reduces mortality from lung cancer in high-risk individuals. Objective To describe the role preferences and information needs of primary care providers (PCPs) in a future organized lung cancer screening program. Methods We purposively sampled PCPs from diverse health regions of Ontario and from different practice models including family health teams and community health centres. We also recruited family physicians with a leadership role in cancer screening. We used focus groups and a nominal group process to identify informational priorities. Two analysts systematically applied a coding scheme to interview transcripts. Results Four groups were held with 34 providers and administrative staff [28 (82%) female, 21 (62%) physicians, 7 (20%) other health professionals and 6 (18%) administrative staff]. PCPs and staff were generally positive about a potential lung cancer screening program but had variable views on their involvement. Informational needs included evidence of potential benefits and harms of screening. Most providers preferred that a new program be modelled on positive features of an existing breast cancer screening program. Lung cancer screening was viewed as a new opportunity to counsel patients about smoking cessation. Conclusions The development of a future lung cancer screening program should consider the wide variability in the roles that PCPs preferred. An explicit link to existing smoking cessation programs was seen as essential. As providers had significant information needs, learning materials and opportunities should be developed with them.

Healthcare professionals’ perspectives on lung cancer screening in the UK: a qualitative study

“…Consistent with the views of primary care providers in a US study, 26 healthcare professionals in this study were generally positive about a potential lung cancer screening programme, but had mixed views about their preparedness. A previous qualitative study in the US showed that GPs suggested that training and ongoing support were fundamental in order to accommodate a new diagnostic tool for lung cancer in their daily practice.…”

“…Similarly, in a US study, financial reimbursement was an important factor that influenced primary care physicians' decisions about screening patients for lung cancer. 28 In line with O'Brien et al's 26 study, participants also suggested that scientific evidence about potential benefits and risks of the screening, along with detailed guidelines, should be available to them. In addition, O'Brien et al 26 highlighted the need to educate patients about the purposes of lung cancer screening in order to participate in shared decision making.…”