Screening chest radiography: results from a Greek cross-sectional survey.
BACKGROUND
Public health authorities worldwide discourage the use of chest radiography as a screening modality, as the diagnostic performance of chest radiography does not justify its application for screening and may even be harmful, since people with false positive results may experience anxiety and concern. Despite the accumulated evidence, various reports suggest that primary care physicians throughout the world still prescribe chest radiography for screening. We therefore set out to index the use of chest radiography for screening purposes among the healthy adult population and to analyze its relationship with possible trigger factors.


METHODS
The study was designed as a cross-sectional survey. Five thousand four hundred and ninety-nine healthy adults, coming from 26 Greek provinces were surveyed for screening practice habits in the nationwide anticancer study. Data were obtained for the use of screening chest radiography. Impact of age, gender, tobacco exposure, family history positive for malignancies and professional-risk for lung diseases was further analyzed.


RESULTS
we found that 20% (n = 1099) of the surveyed individuals underwent chest radiography for screening purposes for at least one time during the previous three years. Among those, 24% do so with a frequency equal or higher than once yearly, and 48% with a frequency equal or higher than every three years. Screening for chest radiography was more commonly adopted among males (OR 1.130, 95% CI 0.988-1.292), pensioners (OR 1.319, CI 1.093-1.593) and individuals with a positive family history for lung cancer (OR 1.251, CI 0.988-1.583). Multivariate analysis confirmed these results.


CONCLUSIONS
Despite formal recommendations, chest radiography for screening purposes was a common practice among the analyzed sample of Greek adults. This practice is of questionable value since the positive predictive value of chest radiography is low. The implementation of even a relatively inexpensive imaging study on a national scale would greatly burden health economics and the workload of radiology departments.
Kamposioras
Konstantinos
K
Panhellenic Association for Continual Medical Research (PACMeR) Sections of Public-Health 28, Karolou st, 10438 Athens, Greece. kambkons1@yahoo.gr
Casazza
Giovanni
G
Mauri
Davide
D
Lakiotis
Velisarios
V
Cortinovis
Ivan
I
Xilomenos
Apostolos
A
Peponi
Christina
C
Golfinopoulos
Vassilis
V
Milousis
Athanasios
A
Kakaridis
Dimitrios
D
Zacharias
Georgios
G
Karathanasi
Ioanna
I
Ferentinos
Georgios
G
Proiskos
Anastasios
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006115:Greece; D019538:Health Care Surveys; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging; D008297:Male; D008400:Mass Chest X-Ray / Q000523:psychology / Q000706:statistics & numerical data*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011320:Primary Health Care / Q000379:methods* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D019564:Unnecessary Procedures