P1.03-055 LuCaS DA: A Lung Cancer Screening Decision Aid to Improve Screening Decisions

Abstract

Although lung cancer (LC) continues to be one of the leading causes of cancer morbidity and mortality world-wide, the NLST trial showed that low dose computed tomography (LDCT) screening can substantially reduce mortality in specific high-risk populations. However, most individuals are not making informed decisions which take into account the risks of screening although US guidelines advocate for informed decision-making. We report preliminary results of a web-based interactive LC decision aid (LuCaS DA) on LC screening knowledge and decision making compared to the US National Cancer Institutes’ web-pages on LC screening. Individuals in the study (n=50; from rural Kentucky and SE Florida, USA) had an elevated risk for lung cancer (n=50) due to smoking. Participants completed a baseline survey and were randomized to viewing the LuCaS DA or the NCI website. After 2 weeks, participants completed an online survey. Surveys collected information on: demographics, health status, smoking history, knowledge of CT screening, decisions about being screened for lung cancer, and decisional conflict about screening. Participants were 52.6 (SD 5.1) years old on average; were majority female (77.1%), White (62.0%), and non-Hispanic (83.7%), and reported have some insurance coverage (88.0%). Most were current daily smokers (70.2%), and overall had smoked an average of 27.9 (SD 7.7) years. Mean Decisional Conflict overall participants was 39.3 (SD 13.5) at baseline and 34.4 (SD 11.1) at 2 week follow up, with no differences between the arms. The percentage of participants show stated that they had made a decision about screening increased slightly from 32.7% at baseline to 37.5% at follow up. Preparedness for making a decision about screening (measured POST only) showed no differences between the arms. There were some increases in knowledge about CT screening and knowledge about LCS guidelines from initial to 2-week follow up. Finally, a qualitative exploration of the LuCaS DA showed that it had high levels of acceptability. DAs can facilitate informed decisions about participation in cancer screening, and US policies have required their use. This is the first study that we are aware of that assesses the use and effects of a lung cancer screening decision aid. These preliminary results show that the LuCaS DA can improve some outcomes, but not consistently more than the NCI webpages. Additional analyses will include the full sample of participants, evaluate a broader array of decision and behavioral outcomes, and consider longer term outcomes of the LuCaS DA.