title: Physicians' knowledge and practice of lung cancer screening: a cross-sectional survey comparing general practitioners, thoracic oncologists, and pulmonologists in France.
abstract: BACKGROUND
  Screening for lung cancer by low-dose computed tomography scan (LDCTS) has been demonstrated to reduce lung cancer-specific and overall mortality rates in high-risk individuals. From trial to clinical practice, it is crucial to obtain an accurate level of knowledge of the physicians who will recruit patients for a screening program. The actual current practice and knowledge of practitioners are unknown. This could be critical to develop dedicated continuous medical education programs.
  
  
  METHODS
  Three groups of French physicians--pulmonologists (PUs), thoracic oncologists (TOs), and general practitioners (GPs)--were surveyed through a dedicated questionnaire on lung cancer screening.
  
  
  RESULTS
  A total of 242 physicians answered the questionnaire; 81% of TOs knew that LDCTS showed efficacy for screening lung cancer compared with 52% of PUs and 18% of GPs (P < .0001). Approximately one third of physicians recommended lung cancer screening in daily practice at the time of the survey, including 53% of PUs, 34% of TOs, and 20% of GPs (P < .001). However, 94% of GPs, 44% of PUs, and 33% of TOs used inappropriate tests, mainly chest radiography. Most GPs proposed screening for all smokers, whereas PUs and TOs reserved screening for heavy smokers (P = .040). Most PUs and TOs recommended annual LDCTS (76%), whereas the majority of GPs sent patients for screening tests every 3 to 5 years (93%; P < .0001).
  
  
  CONCLUSIONS
  These results highlight the interest of physicians for lung cancer screening; meanwhile, our data stress the need for appropriate medical education and recommendations based on available evidence.
authors.affiliation: Department of Respiratory Medicine, Hospices Civils de Lyon, Lyon Sud University Hospital, Pierre Bénite Cedex, France. sebastien.couraud@chu-lyon.fr
authors.forename: Sébastien
authors.initials: S
authors.lastname: Couraud
authors.forename: Nicolas
authors.initials: N
authors.lastname: Girard
authors.forename: Sylvie
authors.initials: S
authors.lastname: Erpeldinger
authors.forename: François
authors.initials: F
authors.lastname: Gueyffier
authors.forename: Gilles
authors.initials: G
authors.lastname: Devouassoux
authors.forename: Guy
authors.initials: G
authors.lastname: Llorca
authors.forename: Pierre Jean
authors.initials: PJ
authors.lastname: Souquet
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer; D005602:France; D058005:General Practitioners; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D008495:Medical Oncology; D010820:Physicians; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011379:Prognosis; D015272:Pulmonary Medicine; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed
keywords: Knowledge; Lung cancer; Practice; Primary care; Screening