Uptake Of Lung Cancer Screening Research Articles

A qualitative study exploring patient motivations for screening for lung cancer.

BackgroundLow-dose computed tomography (LDCT) of the chest for lung cancer screening of heavy smokers was given a ‘B’ rating by the U.S. Preventive Services Task Force (USPSTF) in 2013, and gained widespread insurance coverage in the U.S. in 2015. Lung cancer screening has since had low uptake. However, for those that do choose to screen, little is known about patient motivations for completing screening in real-world practice.ObjectiveTo explore the motivations for screening-eligible patients to screen for lung cancer.MethodsSemi-structured qualitative interviews were conducted with 20 LDCT screen-completed men and women who were members of an integrated mixed-model healthcare system in Washington State. From June to September 2015, participants were recruited and individual interviews performed about motivations to screen for lung cancer. Audio-recorded interviews were transcribed and analyzed using inductive content analysis by three investigators.ResultsFour primary themes emerged as motivations for completing LDCT lung cancer screening: 1) trust in the referring clinician; 2) early-detection benefit; 3) low or limited harm perception; and 4) friends or family with advanced cancer.ConclusionParticipants in our study were primarily motivated to screen for lung cancer based on perceived benefit of early-detection, absence of safety concerns, and personal relationships. Our findings provide new insights about patient motivations to screen, and can potentially be used to improve lung cancer screening uptake and shared decision-making processes.

P2.06-005 An Exploration of Attitudes and Barriers to Uptake of Lung Cancer Screening in at Risk Adults in the United Kingdom

Lung cancer screening targets a high risk subgroup of the population, comprising current and ex-smokers. There are data to suggest that smokers view screening in a nihilistic way and perceive early detection to be of limited use and, as such, are less likely to consider screening participation. Other screening programmes have also shown markedly reduced uptake in those from the most deprived groups. Smoking rates and lung cancer incidence are highest in more socially deprived areas and lung cancer survival is worst in this group. An understanding of the key barriers to engagement with lung cancer screening is therefore vital prior to implementation of a national screening programme.

Racial Disparities in Lung Cancer Screening: An Exploratory Investigation

Background/PurposeLung cancer is the leading cause of cancer death in the United States. Black Americans have the highest rate of lung cancer mortality, due to being diagnosed at later stage. Lung Cancer Screening (LCS) facilitates earlier detection and has been associated with a reduction in cancer death. We investigated LCS utilization and explored racial disparities (Black vs. non-Black) in LCS among patients for whom LCS is clinically indicated. MethodsUsing electronic medical records from the Lifespan Medical System, we randomly selected 200 patients who were likely to meet U. S. Preventive Services Taskforce (USPSTF) guidelines for LCS and mailed each patient a survey to assess LCS eligibility and uptake. ResultsNearly three-quarters (n = 146, 73%) completed the survey and, of survey respondents, 92% (n = 134) were eligible for the study. Among eligible patients, 35% met criteria for LCS; non-Black patients were 90% more likely to meet criteria for LCS than Black patients (44% vs. 27%). Of the patients meeting USPSTF criteria, only 21% reported being screened; eligible non-Black patients were 2.8 times more likely to have had LCS than eligible Black patients (30% vs. 12%). ConclusionsLCS utilization is low despite coverage provided through the Affordable Care Act. Black patients are less likely to qualify for screening and disproportionately less likely to be screened for lung cancer compared with non-Black patients. Targeted intervention strategies are needed to increase referral for and uptake of LCS in patients who are at high risk for developing lung cancer, and for Black patients in particular.

P1.01-028 High Risk Older Smokers’ Perceptions, Attitudes and Beliefs About Lung Cancer Screening

The US Preventive Services Task Force recommends that smokers aged 55-80 should be screened annually with low dose computed tomography (LDCT). Successful implementation of lung cancer screening depends on being able to reach high-risk individuals. This study identified demographic, smoking history, health risk perceptions, knowledge, and attitude factors of older smokers related to LDCT agreement. Using binary logistic regression we produced a predictive model of factors to explain LDCT agreement. As part of a larger Tobacco Attitudes and Beliefs Study, we conducted a cross-sectional, national, online survey of 549 older (≥ 45 years) current and former smokers. Univariate differences between groups for agreement and non-agreement for LDCT was conducted. Using all variables that demonstrated a significant association with LDCT agreement, a binary logistic regression analysis was conducted to predict agreement to have an LDCT. Almost 80% of the sample believed that a person who continues to smoke after the age of 40 has at least a 25% chance of developing lung cancer and if asked, 79.4% would agree to a LDCT. Using Chi Square analyses, nine variables that were significant at the 0.10 level were selected for inclusion in model development. Four of the independent variables made a unique statistically significant contribution to the model: Believes that early detection of lung cancer will result in a good prognosis; Perceives accuracy of LDCT as an important factor in the decision to have a LDCT scan; Believes that they are at high risk for lung cancer; and Believes that a negative LDCT result would decrease worry without encouraging continued smoking. Older smokers are aware of the risks of smoking, are interested in smoking cessation, and most are interested in and positive about LDCT. Cognitive aspects of participation in screening are key to increasing the uptake of lung cancer screening and smoking cessation among high-risk smokers.

High-risk older smokers' perceptions, attitudes, and beliefs about lung cancer screening.

The US Preventive Services Task Force recommends that smokers aged 55–80 should be screened annually with low‐dose computed tomography (LDCT). This study identified demographics, smoking history, health risk perceptions, knowledge, and attitudes factors of older smokers (≥55 years) related to LDCT agreement. Using binary logistic regression, a predictive model of factors to explain LDCT agreement was produced. This is a cross‐sectional, national, online survey of 338 older smokers (≥55 years) with a ≥30 pack‐year smoking history. Over 82% of the sample believed that a person who continues to smoke after the age of 40 has at least a 25% chance of developing lung cancer and 77.3% would “agree to a LDCT today”. Using chi‐square analyses, six variables that were significant at the 0.10 level were selected for inclusion in model development. Four of the independent variables made a unique statistically significant contribution to the model: perceives accuracy of the LDCT as an important factor in the decision to have a LDCT scan; believes that early detection of LC will result in a good prognosis; believes that they are at high risk for lung cancer; and is not afraid of CT scans. Of note, only 10.9% believed that a negative CT scan result would mean that they could continue to smoke. Older smokers are aware of the risks of smoking, are interested in smoking cessation, and most are interested in and positive about LDCT. Cognitive aspects of participation in screening are key to increasing the uptake of lung cancer screening among high‐risk smokers.

Attitudes to participation in a lung cancer screening trial: a qualitative study

BackgroundEarlier diagnosis of lung cancer is key to reducing mortality. New evidence suggests that smokers have negative attitudes to screening and participation in lung cancer screening trials is poor (<1...