Lung Cancer Screening in the Post-NLST Era: Physician Perceptions and Screening Practices (ProjectLUNG)
Source: American Cancer Society Institutional Research Grant
Role: Principal Investigator
Total Direct Costs: $29,988
The goal of this study is to examine PCPs’ knowledge, attitudes, and practices regarding LDCT screening in the post-NLST era among a national sample of PCPs. We aim to determine physicians’ knowledge gaps and screening barriers to develop interventions that will increase their competence in discussing the risks/benefits of screening and their awareness of the recommended screening guidelines.
Evidence from the National Lung Screening Trial (NLST) has shown that annual low-dose computed tomography (LDCT) screening reduces lung cancer mortality for high-risk patients by 20%.This groundbreaking information has spurred the development and revision of screening guidelines from various professional organizations and generated lung cancer screening programs across the county. However, data from primary care physicians (PCP) suggests potential gaps in knowledge of the risks and benefits of LDCT screening and associated practice guidelines. Additionally, little is known about PCPs’ attitudes towards LDCT screening/guidelines and practices. Thus, we are developing and administering a survey among a nationally representative sample of PCPs’ to examine their knowledge, attitudes, and practices regarding LDCT screening. Barriers to integration of LDCT screening such as availability of high-quality screening programs are also addressed.
Our first aim is to evaluate PCPs’ knowledge of the risks and benefits of LDCT screening, target population for screening, recommended screening interval, and practice guidelines. This provides a baseline estimate of PCPs’ level of knowledge and establishes educational deficiencies. Our second aim is to examine PCPs’ attitudes towards LDCT screening and its associated practice guidelines. PCPs’ knowledge and attitudes may impact their screening practices; thus, our third aim examines the extent of risk/benefit information offered to patients and PCPs’ referral patterns for LDCT screening. Potential barriers to PCPs’ discussing and ultimately referring eligible candidates for LDCT screening, such as reimbursement, are also being investigated. Finally, we are evaluating whether PCPs’ knowledge and attitudes regarding LDCT screening are associated with their screening practices. Results from this study are expected to spur the development of patient-, physician-, and systems-level interventions to increase awareness of LDCT screening and associated practice guidelines, with the broader goal of reducing the burden of lung cancer mortality in the U.S. and ensuring appropriate use of CT imaging for cancer screening.