Family Physicians Aren’t Ordering LDCT Lung Cancer Screening

Although the majority of family physicians discuss the use of low-dose CT (LDCT) lung cancer screening with high-risk patients, referrals for screening remain low, according to a study published in Cancer.

Researchers from South Carolina sought to assess the level of knowledge of LDCT use for high-risk patients, and the physicians’ attitudes towards and use of the screening tool. The researchers sent out a 32-item questionnaire to members of the South Carolina Academy of Family Physicians; 101 responses were received.

The results showed that most of the respondents had incorrect knowledge about which organizations recommended screening, and many continued to recommend chest X-ray for lung cancer screening. Although 76% of the physicians did discuss the risks/benefits of screening, fewer than 50% said they made only one or no screening recommendations over the year prior to completing the survey.

Most physicians (98%) felt that LDCT screening increased the odds of detecting disease at earlier stages and that the benefits did outweigh the harms (75%). However, they listed concerns related to the procedure, believing that they could result in:

• Unnecessary procedures (88%)

• Stress/anxiety (52%)

• Radiation exposure (50%)

The researchers concluded that although most family physicians did understand the need for early lung cancer screening with LDCT and had discussions with their patients, few referred their patients for the imaging tests.

“There are gaps in physician knowledge about screening guidelines and reimbursement, and this indicates a need for further educational outreach,” they wrote. “The development of decision aids may facilitate shared decision-making discussions about screening, and targeted interventions may improve knowledge gaps.”