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



A 32-item questionnaire was distributed to members of the South Carolina Academy of Family Physicians in 2015. Descriptive statistics were calculated.



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.



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.
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.|Levine Cancer Institute, Carolinas HealthCare System, Charlotte, North Carolina.
Jennifer L
JL
Ersek
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.|Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
Jan M
JM
Eberth
College of Nursing, University of South Carolina, Columbia, South Carolina.
Karen Kane
KK
McDonnell
Department of Family Medicine, University of South Carolina, Columbia, South Carolina.
Scott M
SM
Strayer
Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
Erica
E
Sercy
College of Nursing, Medical University of South Carolina, Charleston, South Carolina.
Kathleen B
KB
Cartmell
Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.|Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, South Carolina.
Daniela B
DB
Friedman
D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010821:Physicians, Family; D010818:Practice Patterns, Physicians'; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
Medicare; adult; early detection of cancer; lung neoplasms; mass screening