title: Patient-provider discussions about lung cancer screening pre- and post-guidelines: Health Information National Trends Survey (HINTS).
abstract: In 2013, the USPSTF issued a Grade B recommendation that long-term current and former smokers receive lung cancer screening. Shared decision-making is important for individuals considering screening, and patient-provider discussions an essential component of the process. We examined prevalence and predictors of lung cancer screening discussions pre- and post-USPSTF guidelines.
  
  
  
  Data were obtained from two cycles of the Health Information National Trends Survey (2012; 2014). The analyzed sample comprised screening-eligible current and former smokers with no personal history of lung cancer (n=746 in 2012; n=795 in 2014). Descriptive and multiple logistic regression analyses were conducted; patient-reported discussion about lung cancer screening with provider was the outcome of interest.
  
  
  
  Contrary to expectations, patient-provider discussions about lung cancer screening were more prevalent pre-guideline, but overall patient-provider discussions were low in both years (17% in 2012; 10% in 2014). Current smokers were more likely to have had a discussion than former smokers. Significant predictors of patient-provider discussions included family history of cancer and having healthcare coverage.
  
  
  
  The prevalence of patient-provider discussions about lung cancer screening is suboptimal.
  
  
  
  There is a critical need for patient and provider education about shared decision-making and its importance in cancer screening decisions.
authors.affiliation: Indiana University School of Nursing, Indianapolis, IN, USA. Electronic address: lcharris@iu.edu.
authors.forename: Lisa
authors.initials: L
authors.lastname: Carter-Harris
authors.affiliation: Department of Social and Behavioral Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: Andy S L
authors.initials: AS
authors.lastname: Tan
authors.affiliation: Department of Health Outcomes and Policy, and Institute for Child Health Policy, University of Florida College of Medicine, Gainesville, FL, USA.
authors.forename: Ramzi G
authors.initials: RG
authors.lastname: Salloum
authors.affiliation: Kaiser Permanente Northern California Division of Research, Oakland, CA, USA.
authors.forename: Kelly C
authors.initials: KC
authors.lastname: Young-Wolff
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003376:Counseling; D003657:Decision Making; D055088:Early Detection of Cancer; D005260:Female; D017408:Guidelines as Topic; D058015:Health Communication; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010358:Patient Participation / Q000379:methods*; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D011369:Professional-Patient Relations; D012907:Smoking / Q000009:adverse effects
keywords: HINTS; Health Information National Trends Survey; Health communication; Lung cancer screening; Patient-provider discussion; Shared decision making