title: Perceptions and Utilization of Lung Cancer Screening Among Primary Care Physicians.
abstract: Lung cancer screening (LCS) with low-dose computed tomography (LDCT) is effective at reducing lung cancer mortality in high-risk current and former smokers. Despite the fact that screening is recommended by the U.S. Preventative Services Task Force (USPSTF), few eligible patients are screened. We set out to study the barriers to LCS by surveying primary care physicians (PCPs).
  
  
  
  We surveyed a randomly selected sample of 1384 eligible PCPs between January and October 2015, using the American Medical Association Physician Masterfile, though surveys sent by mail, fax, and e-mail. The survey included questions regarding knowledge of LCS guidelines, utilization of LCS over the prior 12 months, and perceptions of barriers to LCS. Training background, years in practice, practice type, and demographics were also collected.
  
  
  
  The survey response rate was 18%. Responders and nonresponders did not differ by practice or demographic characteristics. Of the respondents, 47% indicated that LCS was recommended by the USPSTF, 52% had referred at least one patient for LDCT, and 12% had referred at least one patient to a LCS program over the prior 12 months. Perceived barriers to LCS included uncertainty regarding ther benefit of LCS, concern regarding insurance coverage, and the harm of LCS.
  
  
  
  Although LCS is recommended by the USPSTF, LDCT is utilized in a minority of eligible patients, as reported by surveyed PCPs. Approximately half of PCPs are familiar with USPSTF recommendations for LCS and a number of physician barriers to adherence to guidelines exist. Additional study of physician- and system-based interventions to improve adherence to LCS recommendations is needed.
authors.affiliation: Division of Thoracic Surgery, City of Hope, Duarte, California. Electronic address: draz@coh.org.
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Raz
authors.affiliation: Division of Thoracic Surgery, City of Hope, Duarte, California.
authors.forename: Geena X
authors.initials: GX
authors.lastname: Wu
authors.affiliation: Division of Thoracic Surgery, City of Hope, Duarte, California.
authors.forename: Martin
authors.initials: M
authors.lastname: Consunji
authors.affiliation: Department of Biostatistics, City of Hope, Duarte, California.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Nelson
authors.affiliation: Department of Population Sciences, City of Hope, Duarte, California.
authors.forename: Canlan
authors.initials: C
authors.lastname: Sun
authors.affiliation: Division of Thoracic Surgery, City of Hope, Duarte, California.
authors.forename: Loretta
authors.initials: L
authors.lastname: Erhunmwunsee
authors.affiliation: Department of Population Sciences, City of Hope, Duarte, California.
authors.forename: Betty
authors.initials: B
authors.lastname: Ferrell
authors.affiliation: Department of Population Sciences, City of Hope, Duarte, California.
authors.forename: Virginia
authors.initials: V
authors.lastname: Sun
authors.affiliation: Division of Thoracic Surgery, City of Hope, Duarte, California.
authors.forename: Jae Y
authors.initials: JY
authors.lastname: Kim
mesh_terms: D015331:Cohort Studies; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010465:Perception; D058007:Physicians, Primary Care; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Computed tomography; Lung cancer screening; NSCLC; Primary care; Survey