Lung Cancer Screening Knowledge and Perceived Barriers Among Physicians in the United States.
Lung Cancer Screening Knowledge and Perceived Barriers Among Physicians in the United States.
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DOI：
10.1016/j.jtocrr.2022.100331
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发表时间：
2022-07
影响因子：
--
通讯作者：
Steinberg, Michael B.
中科院分区：
文献类型：
--
作者：
Kota, Karthik J.;Ji, Stephanie;Bover-Manderski, Michelle T.;Delnevo, Cristine D.;Steinberg, Michael B.
肺癌仍然是美国癌症死亡的主要原因，历来都是在病程晚期才被发现。低剂量计算机断层扫描 (LDCT) 可将肺癌死亡率降低 20%，目前已被临床实践指南推荐。然而，与其他癌症筛查方式相比，LDCT 的利用率仍然较低。这项研究调查了美国各地的办公室初级保健医生，以更好地了解 LDCT 的使用情况。 2019 年 4 月至 7 月期间，对从美国医学会医师主档案中选出的 1500 名家庭和内科医生进行了有关 LDCT 实践、资格、临床情况和感知障碍的调查。美国民意研究协会的回复率为59%（652名受访者）； 599 人完成了有关肺癌筛查的补充问题。共有 88% 的受访者在上一年讨论过 LDCT，78% 的受访者至少订购过一次 LDCT。大多数人 (59%) 了解 LDCT 的烟草暴露标准并正确识别适当的临床情况（49%–86% 回答正确）。不到一半的受访者正确确定了年龄资格标准（44%–45% 回答正确）。一般来说，男性医生、1990 年以后毕业的医生和家庭医学医生更有可能报告有关 LDCT 资格的准确知识。 LDCT 面临的最大障碍是患者的费用（48% 被认为是主要障碍）、保险不涵盖筛查（46% 主要）以及患者不知道肺癌筛查（40% 主要）。有关肺癌筛查的知识和实践正在改善，但仍不理想。最常见的障碍仍然是基于成本或保险，这表明需要采取基于系统的应对措施来提高认识并减少 LDCT 的利用不足。
Lung cancer remains the leading cause of cancer death in the United States and has historically been detected late in its course. Low-dose computed tomography scan (LDCT) reduces lung cancer mortality by 20% and is currently recommended by clinical practice guidelines. However, compared with other cancer screening modalities, LDCT utilization remains low. This study surveyed office-based primary care physicians across the United States to better understand LDCT utilization. A total of 1500 family and internal medicine physicians selected from the American Medical Association’s physician master file were surveyed between April and July 2019 regarding LDCT practices, eligibility, clinical scenarios, and perceived barriers. The American Association for Public Opinion Research response rate 3 was 59% (652 respondents); 599 completed supplemental questions regarding lung cancer screening. A total of 88% of respondents discussed LDCT in the previous year, and 78% had ordered at least one LDCT. Most (59%) knew the tobacco exposure criteria for LDCT and correctly identified appropriate clinical scenarios (49%–86% responded correctly). Less than half of respondents correctly identified the age eligibility criteria (44%–45% responded correctly). In general, male physicians, those who graduated after 1990, and family medicine physicians were more likely to report accurate knowledge regarding LDCT eligibility. The top perceived barriers to LDCT were cost to the patient (48% identified as a major barrier), insurance not covering screening (46% major), and patients being unaware of lung cancer screening (40% major). Knowledge and practices about lung cancer screening are improving, though remain suboptimal. The most common barriers remain cost or insurance-based and suggest the need for a systems-based response to increase awareness and reduce the underutilization of LDCT.
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影响因子：
5.7
作者：
Carroll, Nikki M.;Burnett-Hartman, Andrea N.;Ritzwoller, Debra P.
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Ritzwoller, Debra P.
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通讯作者：
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