EP1.11-14 Knowledge and Perspectives of Indian Medical Practitioners to Lung Cancer: A Regional Sample Survey

Abstract

Lung cancer leads cancer-associated mortality figures in India. According to various cancer registries, It’s a pervasive problem with incidence expected to rise to 67,000 new cases per year by 2020. Especially concerning are limited health resources to tackle this problem in terms of specialty centers and trained staff. Adding to woes are poor knowledge, and practices among general practitioners (GPs) pertaining to lung cancer screening and referral. Thereby putting an additional burden on the constrained Indian health care system as a majority of cases are diagnosed at advanced stages leading to poorer prognosis and high treatment costs. A descriptive online survey was developed and pilot tested for GPs with Bachelor degree in Medicine & Surgery (MBBS) using Google survey forms. Google platform was selected for its wide outreach and use by GPs in northern India. The survey was done over 1 month period and included items related to etiopathology and diagnosis of Lung Cancer. The survey adopted a stratified sampling strategy for representation, and data collected were completely anonymous. A total of 2674 complete responses were collected. Majority of GPs were in the private sector (67.68%) with a mean work experience of 8.93±6.70 years. An average of 10 (10.45±7.10) Lung cancer cases were attended by GPs with majority presenting with non-resolving cough and/or hemoptysis (66%). Most common risk factors reported were cigarette smoking (93.27%) and exposure to chemicals (74.49%). Only a quarter of GPs identified lung cancer mortality being the highest (29.09%) with attribution to smoking (23.60%). Only 69.10% GPs advocated Lung cancer screening for current and past smokers. Only 30.89% GPs affirmed that a substantial reduction in mortality (95%) can be achieved by timely and proper screening. Only a quarter (25.46%) GPs reported low dose CT Scan (LDCT) as best modality lung cancer screening. 1943 (72.66%) GPs reported tissue sample biopsy as a method of diagnosis followed by CT scan (58.18%). Histopathology (85.48%) and molecular markers (74.49%) were frequently reported to guide therapeutic decision making. Based on the survey, It can be concluded that knowledge of Indian GPs for Lung cancer is deficient in wake of high disease burden. Poor suspicion and detection of lung malignancy at early stages devoid patients of better prognosis and outcomes. Therefore it is recommended that sensitization workshops and training of GPs in opportunistic cancer screening and referral protocols be done.