PC providers have knowledge gaps in lung cancer screening

Key clinical point: Patients at high risk for lung cancer are more likely to receive screening when their primary care provider is familiar with lung cancer screening guidelines.

Major finding: 47% of respondents knew three or more guideline components and 24% knew none.

Data source: Online survey of 212 primary care providers.

Disclosures: Dr. Lewis and her coauthors reported having no financial disclosures.




CHICAGO – Nearly one-fourth of primary care providers were unaware of current lung cancer screening guidelines in a survey of 212 PC providers in North Carolina, a state with one of the nation’s highest lung cancer death rates.

Only 12% of respondents ordered low-dose computed tomography (LDCT) in the past year to screen their patients at high risk for lung cancer, while 21% ordered a chest x-ray, a nonrecommended screening test, said Dr. Jennifer Lewis of Wake Forest University, Winston-Salem, N.C.

Dr. Jennifer Lewis Courtesy of Wake Forest Baptist Health
Dr. Jennifer Lewis

The use of LDCT screening for high-risk patients has been recommended by multiple health care organizations including the American College of Chest Physicians, American Lung Association, and U.S. Preventative Services Task Force. The 2013 USPSTF recommendations call for annual LDCT screening for adults aged 55-80 years who have a 30–pack-year smoking history and currently smoke or have quit within the past 15 years.

The survey found that 67% of providers knew screening was recommended for current and former smokers, but less than half knew the eligible age to initiate screening in any guideline is 50-55 years (35%), the eligible age to stop screening is 75-80 years (29%), and that a 1-year screening interval is recommended (25%).

Only 47% of respondents knew three or more of the guideline components and 24% knew no components.

Providers who knew three or more guideline components, however, were significantly more likely to use LDCT screening (P = .0002), Dr. Lewis said during a briefing at the 2014 Chicago Multidisciplinary Symposium in Thoracic Oncology.

The online survey was sent to 488 primary care providers, including physicians, physician assistants, and nurse practitioners, affiliated with Wake Forest Baptist Health. Of the 293 respondents (60%), 212 providers cared for patients older than age 40 years in the past year and were eligible for the study.

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