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)
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DOI：
10.1016/j.pec.2016.05.014
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发表时间：
2016-11-01
影响因子：
3.5
通讯作者：
Young-Wolff, Kelly C.
中科院分区：
文献类型：
--
作者：
Carter-Harris, Lisa;Tan, Andy S. L.;Young-Wolff, Kelly C.
目的：2013年，USPSTF发布了B级建议，要求长期吸烟者和既往吸烟者接受肺癌筛查。共同决策对于考虑筛查的个人来说非常重要，而患者与提供者的讨论是该过程的重要组成部分。我们检查了 USPSTF 指南之前和之后肺癌筛查讨论的患病率和预测因素。方法：数据来自两个周期的健康信息国家趋势调查（2012 年；2014 年）。分析样本包括符合筛查资格的当前和既往吸烟者，且无肺癌个人史（2012 年 n = 746 人；2014 年 n = 795 人）。进行了描述性和多元逻辑回归分析；患者报告的与提供者关于肺癌筛查的讨论是感兴趣的结果。 结果：与预期相反，患者与提供者关于肺癌筛查的讨论在指南出台前更为普遍，但这两年患者与提供者之间的总体讨论率较低（2012 年为 17%；2014 年为 10%）。当前吸烟者比以前吸烟者更有可能进行讨论。患者与提供者讨论的重要预测因素包括癌症家族史和医疗保险。结论：患者与提供者关于肺癌筛查的讨论的普遍程度并不理想。实践意义：迫切需要对患者和提供者进行关于共同决策及其在癌症筛查决策中的重要性的教育。 (C) 2016 Elsevier Ireland Ltd. 保留所有权利。
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 decisionmaking and its importance in cancer screening decisions. (C) 2016 Elsevier Ireland Ltd. All rights reserved.