TY - JOUR
T1 - A national survey of primary care physicians
T2 - Perceptions and practices of low-dose CT lung cancer screening
AU - Eberth, Jan M.
AU - McDonnell, Karen Kane
AU - Sercy, Erica
AU - Khan, Samira
AU - Strayer, Scott M.
AU - Dievendorf, Amy C.
AU - Munden, Reginald F.
AU - Vernon, Sally W.
N1 - Funding Information:
This work was support by Supporting Outstanding Academic Research Seed Grants at USC (SOAR-USC), 124275-IRG-13-043-01-IRG , from the American Cancer Society . The authors wish to thank our graduate assistants and interns, namely Cassie Odahowski, Sazid Khan, Lauren Blew, and Debra Warden, for their assistance with data collection and management. We also thank Dr. Suzanne K. Linder, former Assistant Professor in the Division of Rehabilitation Sciences at the University of Texas Medical Branch at Galveston, for her suggestions and edits to the survey.
Publisher Copyright:
© 2018
PY - 2018/9
Y1 - 2018/9
N2 - Soon after the National Lung Screening Trial, organizations began to endorse low-dose computed tomography (LCDT) screening for lung cancer in high-risk patients. Concerns about the risks versus benefits of screening, as well as the logistics of identifying and referring eligible patients, remained among physicians. This study aimed to examine primary care physicians' knowledge, attitudes, referral practices, and associated barriers regarding LDCT screening. We administered a national survey of primary care physicians in the United States between September 2016 and April 2017. Physicians received up to 3 mailings, 1 follow-up email, and received varying incentives to complete the survey. Overall, 293 physicians participated, for a response rate of 13%. We used weighted descriptive statistics to characterize participants and their responses. Over half of the respondents correctly reported that the US Preventive Services Task Force recommends LDCT screening for high-risk patients. Screening recommendations for patients not meeting high-risk criteria varied. Although 75% agreed that the benefits of LDCT screening outweigh the risks, fewer agreed that there is substantial evidence that screening reduces mortality (50%). The most commonly reported barriers to ordering screening included prior authorization requirements (57%), lack of insurance coverage (53%), and coverage denials (31%). The most frequently cited barrier to conducting LDCT screening shared decision making was patients' competing health priorities (42%). Given the impact of physician recommendations on cancer screening utilization, further understanding of physicians' LDCT screening attitudes and shared decision-making practices is needed. Clinical practice and policy changes are also needed to engage more patients in screening discussions.
AB - Soon after the National Lung Screening Trial, organizations began to endorse low-dose computed tomography (LCDT) screening for lung cancer in high-risk patients. Concerns about the risks versus benefits of screening, as well as the logistics of identifying and referring eligible patients, remained among physicians. This study aimed to examine primary care physicians' knowledge, attitudes, referral practices, and associated barriers regarding LDCT screening. We administered a national survey of primary care physicians in the United States between September 2016 and April 2017. Physicians received up to 3 mailings, 1 follow-up email, and received varying incentives to complete the survey. Overall, 293 physicians participated, for a response rate of 13%. We used weighted descriptive statistics to characterize participants and their responses. Over half of the respondents correctly reported that the US Preventive Services Task Force recommends LDCT screening for high-risk patients. Screening recommendations for patients not meeting high-risk criteria varied. Although 75% agreed that the benefits of LDCT screening outweigh the risks, fewer agreed that there is substantial evidence that screening reduces mortality (50%). The most commonly reported barriers to ordering screening included prior authorization requirements (57%), lack of insurance coverage (53%), and coverage denials (31%). The most frequently cited barrier to conducting LDCT screening shared decision making was patients' competing health priorities (42%). Given the impact of physician recommendations on cancer screening utilization, further understanding of physicians' LDCT screening attitudes and shared decision-making practices is needed. Clinical practice and policy changes are also needed to engage more patients in screening discussions.
KW - Computed tomography
KW - Early detection of cancer
KW - Lung cancer
KW - Mass screening
KW - Physicians
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U2 - 10.1016/j.pmedr.2018.05.013
DO - 10.1016/j.pmedr.2018.05.013
M3 - Article
AN - SCOPUS:85047630552
VL - 11
SP - 93
EP - 99
JO - Preventive Medicine Reports
JF - Preventive Medicine Reports
SN - 2211-3355
ER -