Knowledge of, attitudes toward, and use of low-dose computed tomography for lung cancer screening among family physicians
Knowledge of, attitudes toward, and use of low-dose computed tomography for lung cancer screening among family physicians
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DOI：
10.1002/cncr.29944
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发表时间：
2016-08-01
期刊：
影响因子：
6.2
通讯作者：
Friedman, Daniela B.
中科院分区：
文献类型：
--
作者：
Ersek, Jennifer L.;Eberth, Jan M.;Friedman, Daniela B.
背景：全国肺部筛查试验的结果显示，当高危患者接受低剂量计算机断层扫描(LDCT)与胸部X光(CXR)筛查时，肺癌死亡率降低20%，全因死亡率降低6.7%。美国预防服务工作组已经发布了低密度CT筛查的B级建议，医疗保险和医疗补助服务中心以及私营保险公司现在在某些条件下承担筛查费用。本研究的目的是评估家庭医生对LDCT肺癌筛查的知识、态度和使用情况。方法2015年向南卡罗来纳州家庭医生学院的成员分发了包含32个项目的问卷。描述性统计被计算出来。结果101名受访者中，大多数人不正确地知道哪些组织推荐筛查。许多内科医生继续推荐CXR用于肺癌筛查。大多数人认为LDCT筛查增加了在早期阶段发现疾病的几率(98%)，而且好处大于坏处(75%)。担心包括不必要的手术(88%)、压力/焦虑(52%)和辐射暴露(50%)。大多数医生以一定的身份与他们的患者讨论筛查的风险/好处(76%)；然而，超过50%的医生报告在过去一年中提出了一项或没有提出筛查建议。结论大多数家庭医生报告与肺癌高危患者讨论LDCT；然而，转诊人数仍然很低。医生在筛查指南和报销方面的知识存在差距，这表明需要进一步的教育推广。决策辅助工具的开发可能会促进关于筛查的共同决策讨论，而有针对性的干预措施可能会改善知识差距。癌症2016；122：2324-2331。(C)2016年美国癌症协会。
BACKGROUNDThe results of the National Lung Screening Trial showed a 20% reduction in lung cancer mortality and a 6.7% reduction in all-cause mortality when high-risk patients were screened with low-dose computed tomography (LDCT) versus chest x-ray (CXR). The US Preventive Services Task Force has issued a grade B recommendation for LDCT screening, and the Centers for Medicare and Medicaid Services and private insurers now cover the screening cost under certain conditions. The purpose of this study was to assess the knowledge of, attitudes toward, and use of LDCT screening for lung cancer among family physicians.METHODSA 32-item questionnaire was distributed to members of the South Carolina Academy of Family Physicians in 2015. Descriptive statistics were calculated.RESULTSThere were 101 respondents, and most had incorrect knowledge about which organizations recommended screening. Many physicians continued to recommend CXR for lung cancer screening. Most felt that LDCT screening increased the odds of detecting disease at earlier stages (98%) and that the benefits outweighed the harms (75%). Concerns included unnecessary procedures (88%), stress/anxiety (52%), and radiation exposure (50%). Most physicians discussed the risks/benefits of screening with their patients in some capacity (76%); however, more than 50% reported making 1 or no screening recommendations in the past year.CONCLUSIONSMost family physicians report discussing LDCT with patients at high risk for lung cancer; however, referrals remain low. There are gaps in physician knowledge about screening guidelines and reimbursement, and this indicates a need for further educational outreach. The development of decision aids may facilitate shared decision-making discussions about screening, and targeted interventions may improve knowledge gaps. Cancer 2016;122:2324-2331. (c) 2016 American Cancer Society.