Lung cancer screening: what do long‐term smokers know and believe?

Carter‐Harris, Lisa; Ceppa, Duy Khanh P.; Hanna, Nasser H.; Rawl, Susan M.

doi:10.1111/hex.12433

Cited by 137 publications

(154 citation statements)

References 22 publications

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“…Patient-provider discussions and subsequent healthcare provider recommendations are associated with increased cancer screening behavior in other types of cancer such as breast and colorectal with patient-provider discussions occurring in approximately 50 to 80% of screening eligible patients [15-17]. However, unlike many cancers, there is a higher level of stigma associated with lung cancer [18,19], which may be contributing to the overall low prevalence of patient-provider discussions in lung cancer screening. Smokers are a unique population different from those targeted for other types of cancer screening.…”

Section: Discussionmentioning

confidence: 99%

“…Smokers are a unique population different from those targeted for other types of cancer screening. Smokers experience stigma, battle an addiction to nicotine, and perceive blame from others related to the perceived self-infliction of tobacco-related diseases secondary to lifestyle choices [18,19]. Therefore, perceived stigma seems relevant in lung cancer screening.…”

Section: Discussionmentioning

confidence: 99%

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Patient-provider discussions about lung cancer screening pre- and post-guidelines: Health Information National Trends Survey (HINTS)

Carter‐Harris

Tan

Salloum

et al. 2016

Patient Education and Counseling

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Objective In 2013, the USPSTF issued a Grade B recommendation that long-term current and former smokers receive lung cancer screening. Shared decision-making is important for individuals considering screening, and patient-provider discussions an essential component of the process. We examined prevalence and predictors of lung cancer screening discussions pre- and post-USPSTF guidelines. Methods Data were obtained from two cycles of the Health Information National Trends Survey (2012; 2014). The analyzed sample comprised screening-eligible current and former smokers with no personal history of lung cancer (n=746 in 2012; n=795 in 2014). Descriptive and multiple logistic regression analyses were conducted; patient-reported discussion about lung cancer screening with provider was the outcome of interest. Results Contrary to expectations, patient-provider discussions about lung cancer screening were more prevalent pre-guideline, but overall patient-provider discussions were low in both years (17% in 2012; 10% in 2014). Current smokers were more likely to have had a discussion than former smokers. Significant predictors of patient-provider discussions included family history of cancer and having healthcare coverage. Conclusions The prevalence of patient-provider discussions about lung cancer screening is suboptimal. Practice Implications There is a critical need for patient and provider education about shared decision-making and its importance in cancer screening decisions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Patient-provider discussions about lung cancer screening pre- and post-guidelines: Health Information National Trends Survey (HINTS)

Carter‐Harris

Tan

Salloum

et al. 2016

Patient Education and Counseling

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“…11 Another recent qualitative survey study of smokers reported that knowledge of the existence of LCS was low and that patient barriers to screening included inconvenience, stigma associated with smoking as a reason to avoid screening, and distrust of the healthcare system. 12 Even less is known about physician barriers to LCS. Possible physician barriers to LCS include a lack of awareness regarding guidelines for LCS, lack of time to counsel patients regarding LCS, or misperceptions regarding the risks and benefits of LCS.…”

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confidence: 99%

Perceptions and Utilization of Lung Cancer Screening Among Primary Care Physicians

Raz

Consunji

et al. 2016

Journal of Thoracic Oncology

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Background Lung cancer screening (LCS) with low dose CT scan (LDCT) is effective at reducing lung cancer mortality in high risk current and former smokers. Despite being recommended by the U.S. Preventative Services Task Force (USPSTF), few eligible patients are screened. We set out to study the barriers to LCS by surveying primary care physicians (PCPs). Methods We surveyed a randomly selected sample of 1384 eligible primary care physicians (PCPs) between January and October 2015, using the American Medical Association Physician Masterfile, though surveys sent by mail, fax, and email. The survey included questions regarding knowledge of LCS guidelines, utilization of LCS over the prior 12 months, and perceptions of barriers to LCS. Training background, years in practice, practice type, and demographics were also collected. Results The survey response rate was 18%. Responders and non-responders did not differ by practice and demographic characteristics. 47% indicated that LCS was recommended by the USPSTF. 52% had referred any patient for LDCT and 12% had referred any patient to a LCS program over the prior 12 months. Perceived barriers to LCS included uncertainty regarding benefit of LCS, concern regarding insurance coverage, and harms of LCS. Conclusions Although LCS is recommended by USPSTF, LDCT is utilized in a minority of eligible patients, as reported by surveyed PCPs. About half of PCPs are familiar with USPSTF recommendations for LCS and a number of physician barriers to guideline adherence exist. Additional study on physician and system based interventions to improve adherence with LCS recommendations is needed.

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“…Smokers experience stigma, battle an addiction to nicotine, and perceive blame from others related to the perceived self-infliction of tobacco-related diseases secondary to their lifestyle choice, and in turn, individual health beliefs related to cancer screening may be influenced by an individuals’ smoking status. Based on our preliminary qualitative work, variables such as health beliefs (perceived risk, perceived benefits, perceived barriers, and self-efficacy) as well as perceived stigma, medical mistrust, cancer fatalism, fear, and worry seem to be uniquely relevant in lung cancer screening (Carter-Harris, Ceppa, Hanna, & Rawl, 2015). …”

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Lung Cancer Screening Participation: Developing a Conceptual Model to Guide Research

Carter‐Harris

Davis

Rawl

2016

Res Theory Nurs Pract

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Purpose To describe the development of a conceptual model to guide research focused on lung cancer screening participation from the perspective of the individual in the decision-making process. Methods Based on a comprehensive review of empirical and theoretical literature, a conceptual model was developed linking key psychological variables (stigma, medical mistrust, fatalism, worry, and fear) to the health belief model and precaution adoption process model. Results Proposed model concepts have been examined in prior research of either lung or other cancer screening behavior. To date, a few studies have explored a limited number of variables that influence screening behavior in lung cancer specifically. Therefore, relationships among concepts in the model have been proposed and future research directions presented. Conclusion This proposed model is an initial step to support theoretically based research. As lung cancer screening becomes more widely implemented, it is critical to theoretically guide research to understand variables that may be associated with lung cancer screening participation. Findings from future research guided by the proposed conceptual model can be used to refine the model and inform tailored intervention development.

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Lung cancer screening: what do long‐term smokers know and believe?

Cited by 137 publications

References 22 publications

Patient-provider discussions about lung cancer screening pre- and post-guidelines: Health Information National Trends Survey (HINTS)

Patient-provider discussions about lung cancer screening pre- and post-guidelines: Health Information National Trends Survey (HINTS)

Perceptions and Utilization of Lung Cancer Screening Among Primary Care Physicians

Lung Cancer Screening Participation: Developing a Conceptual Model to Guide Research

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