Patient perception and adherence to lung cancer screening in those who meet eligibility criteria.

JOURNAL OF CLINICAL ONCOLOGY(2023)

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摘要
e22503 Background: The US Preventive Services Task Force reported 14.2 million Americans qualify for lung cancer screening. As per the Lung Cancer Screening Trial, using low dose computed tomography (LDCT) for screening demonstrated a 20% reduction in lung cancer-related deaths. Despite that, the 2022 State of Lung Cancer Report from the American Lung Association indicates that only 5.8% of eligible patients in the U.S. undergo lung cancer screening. Indiana, where this study was conducted, is ranked 46/50 and 44/50 in the number of smokers and incidence of lung cancer, respectively. A statewide lung cancer screening effort is greatly needed. Methods: The study population was recruited between 10/2022 and 1/2023 from 2 hospitals within the Indiana University Health network. Patients were surveyed during their primary care clinic visits. Eligibility criteria included a 20-pack-year or more history of smoking, an age between 50 and 80, and were either current smokers or quit within the last 15 years. A survey was designed with open-ended questions and was standardized to all participants. The questions covered the cohort's familiarity with lung cancer screening, the associated risk with smoking, and the potential hindrances to getting screened. After discussing the benefits and risks of the screening, the patients were then asked if they would consider getting an initial LDCT. Patients' compliance with their scheduled LDCT date was recorded. Results: 175 persons met eligibility criteria, and all reported understanding the link between smoking and lung cancer; however, 147 (84%) were unfamiliar with the need for screening. The barriers to screening, as described by the cohort, included fear of cancer diagnosis (33.7%), lack of symptoms (22.2%), the stigma associated with being a smoker (12.6%), doubting the usefulness of screening (12.0%), not wanting to quit smoking (6.9%), cost of LDCT in those under 65 (4.6%), fear of exposure to radiation (4.0%), believing that cancer treatment would be worse than continuing to smoke (2.3%), and mistrust of the medical system (1.7%). When the patients were educated on LDCT’s benefits and risks, 118 patients (67.4%) perceived it as beneficial and elected to get it scheduled. Of the 118 patients, 64 (54.2%) attended their scheduled initial LDCT. Conclusions: The patient’s perceptions of screening varied, and from our data, it appears that most smokers were unaware of the need for a LDCT and had multiple concerns. Once the patients were educated about the benefits and risks of lung cancer screening, most scheduled an initial LDCT and perceived it to be beneficial.
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lung cancer,patient perception,adherence,screening
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