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Family Physicians Unaware of Lung Cancer Screening Recommendations

COLUMBIA, SC – Family physicians aren’t aware enough of appropriate lung cancer screening, according to a new survey.

A study published online recently by the journal Cancer reports that less than half of family physicians in a recent survey agreed that screening reduces lung cancer-related deaths, even though clinical trials have shown that lung cancer screening using low-dose computed tomography (LDCT) can detect lung cancers early and reduce lung cancer mortality.

University of South Carolina researchers noted that most of the physician respondents also were unaware of current recommendations on lung cancer screening in high-risk patients.

Background information in the article notes that the United States Preventive Services Task Force, Medicare, and multiple professional societies and organizations support the use of LDCT screening for high-risk patients, such as certain current and former smokers. On the other hand, associations such as the American Academy of Family Physicians maintain that there is not enough evidence to either recommend or discourage the use of LDCT screening.

To evaluate the knowledge, attitudes, and practice patterns of family physicians related to lung cancer screening using LDCT, the researchers distributed a 32-item questionnaire to South Carolina Academy of Family Physicians members in 2015.

Most of the 101 respondents had incorrect knowledge about which organizations recommend screening. In addition, although 98% said they believed that LDCT screening increases the likelihood of detecting disease at earlier stages, only 41% thought that translated into reduced lung cancer-related deaths.

The majority, 75%, said they felt that LDCT's benefits outweigh potential harms, but 88% had concerns about unnecessary procedures, 52% had concerns about patient stress/anxiety about screening, and 50% had concerns about radiation exposure.

When asked whether they would recommend lung cancer screening with LDCT for a 60-year-old patient with a 30 pack-per-year smoking history, 12% of the physicians responded that they would not recommend any screening, and 9% stated they would recommend a chest X-ray.

"Education is needed to bridge these knowledge gaps and lay a foundation on which physicians can base their treatment recommendations," said lead researcher Jan Eberth, PhD, MSPH. "With the Centers for Medicare & Medicaid Services now offering reimbursement to primary care providers to engage in shared decision-making with their patients about lung cancer screening, it is vital that providers have an accurate understanding of the eligibility criteria for screening and potential risks and benefits. Decision aids may be a useful tool to facilitate these treatment discussions."