UC Berkeley Prevention Research Center

项目总结 肺癌是美国癌症死亡的主要原因。国家肺部筛查试验(NLST) 低剂量计算机断层扫描(CT)在高危人群中筛查肺癌的研究 显著降低肺癌死亡率，尽管这也与高假阳性率有关 导致过度诊断和更多的焦虑。美国癌症协会目前推荐CT 对符合NLST原始资格标准的人进行筛查，美国预防工作组将 在2013年提交一份关于这一主题的科学报告。目前的建议鼓励医生和患者 考虑CT筛查的好处、风险和局限性，以做出共同的决定。像吸烟一样 是肺癌的主要危险因素，CT筛查的讨论也为 促进戒烟和预防复发。拟议研究的最终目标是开发 有助于医患讨论肺癌风险、CT检查和吸烟的信息 戒毒/预防复发。我们的具体目标如下：目标1.检查患者对 对肺癌风险、CT检查、戒烟/复发预防以及 每个人都有障碍/促进者。我们将对多种族(黑人、拉丁裔和 白人)双语(英语或西班牙语)现任(n=15)和曾经(n=15)符合NLST的吸烟者 标准和已经接受过CT筛查的患者(n=10)。参与者将从以下地点招募 加州大学旧金山分校的患者。目标2.评估医生对 向患者提供肺癌风险、CT筛查和戒烟信息的障碍/促进者。 我们将对来自旧金山的16名初级保健医生进行半结构化采访 湾区合作研究网络。目的3.评估讨论肺的现行方法和做法 癌症风险和CT筛查结果。我们将对10名患者和他们的 在加州大学旧金山分校接受CT筛查的肺科医生，随后进行半结构化访谈。我们 将对这些数据点进行三角测量，以确定医生和他们的 病人。 我们希望我们的研究能产生一套具体的建议，帮助医生进行沟通 与患者了解肺癌风险和CT筛查，并促进 高危患者。这些建议还将帮助医生鼓励戒烟和 在他们的病人中预防复发。

PROJECT SUMMARY Lung cancer is the leading cause of cancer death in the U.S. The National Lung Screening Trial (NLST) documented that low-dose computed tomography (CT) lung cancer screening among individuals at high risk significantly reduced lung cancer mortality, although it was also associated with a high rate of false positives leading to over-diagnosis and increased anxiety. The American Cancer Society currently recommends CT screening for those who meet the NLST's original eligibility criteria and the U.S. Preventive Task Force will provide a scientific report on the subject in 2013. Current recommendations encourage physicians and patients to consider the benefits, risks, and limitations of CT screening to make a shared decision. As cigarette smoking is the leading risk factor for lung cancer, CT screening discussions also present a "teachable moment" to promote smoking cessation and relapse prevention. The ultimate goal of the proposed research is to develop messages that will facilitate physician-patient discussions of lung cancer risk, CT screening, and smoking cessation/relapse prevention. Our specific aims are as follows: Aim 1. Examine patients' understanding of and concerns about lung cancer risk, CT screening, smoking cessation/ relapse prevention and the barriers/facilitators of each. We will conduct semi-structured interviews with multiethnic (black, Latino and White) bilingual (English or Spanish-speaking) current (n=15) and former (n=15) smokers who match NLST criteria and with patients (n=10) who have already undergone CT screening. Participants will be recruited from patients at the University of California, San Francisco. Aim 2. Assess physicians' perspectives on, and barriers/facilitators of providing lung cancer risk, CT screening and smoking cessation information to patients. We will conduct semi-structured interviews with 16 primary care physicians identified from the San Francisco Bay Area Collaborative Research Network. Aim 3. Assess current methods and practices of discussing lung cancer risk and CT screening results. We will conduct direct observation of 10 patients and their pulmonologists at the point of undergoing CT screening at UCSF, followed by semi-structured interviews. We will triangulate these data points to determine optimal communication strategies for physicians and their patients. We expect our research to produce a set of specific recommendations that will help physicians to communicate with their patients about lung cancer risk and CT screening, and promote informed decision-making among patients at high risk. These recommendations will also help physicians to encourage smoking cessation and relapse prevention among their patients.