Rates of Lung Cancer Screening Discussions Low Between Physicians and Patients

The rate of discussions between physicians and patients regarding lung cancer screenings is very low, according to a study recently published in Cancer, Epidemiology, Biomarkers & Prevention. Improved communication about lung cancer screening in smokers will serve to decrease the burden created by lung cancer.

This study included 9443 individuals from the National Cancer Institute’s Health Information National Trends Survey from the years 2012, 2014, and 2017. The answer to the question, “Past year, have you talked with your doctor about having a test to check for lung cancer?” was used. Associations between samples’ features and lung cancer screening discussions were calculated using the Pearson chi-squared test, with logistic regression used to estimate the likelihood of participants either attempting or intending to quit.

Crude estimates of discussion regarding lung cancer screening between physicians and patients were 6.7% in 2012 and decreased to 4.2% in 2014 and 4.3% in 2017 (P =.002). Discussion was most common in smokers between the ages of 55 and 74 years in 2012 at 26.8%, in smokers aged ≥74 years in 2014 at 23.5%, and again in smokers aged ≥74 years in 2017 at 22.1%.

Adjusted multivariable logistic regression revealed a higher odds of discussion in individuals surveyed in 2014 (odds ratio [OR], 1.70; 95% CI, 1.26-2.29; P <.001), as well as in those aged 55 to 77 years (OR, 3.25; 95% CI, 2.28-4.61; P =.013), aged ≥77 years (OR, 4.77; 95% CI, 2.76-8.27; P <.0001), or those who were current (OR, 3.93; 95% CI, 2.73-5.66; P <.0001) or former (OR, 1.90; 95% CI, 1.33-2.73; P <.001) smokers. Multivariable analysis did not reveal significant associations between attempt or intention to quit and lung cancer screening discussions.

Study limitations included a lack of documentation on the type and content of the lung cancer screening technique discussed, a lack of data on pack-year history, a cross-sectional design, a lack of specificity on a question regarding a test to check for lung cancer, and no data on impact of provider factors.

The study researchers concluded that “the very low rate of communication on lung cancer screening was initiated in physician-patient encounters. …Better recognition of the effectiveness of lung cancer screening among people who are current or former smokers at a high risk of lung cancer and harms of lung cancer screening among ineligible population is warranted. Improved communication regarding lung cancer screening by primary care providers will help to reduce the economic and social burdens of lung cancer and reduce lung cancer-related mortality, as well as the loss of quality of life among high-risk smokers.”

Reference

Huo J, Hong Y-R, Bian J, Guo Y, Wilkie DJ, Mainous III AG. Low rates of patient-reported physician-patient discussion about lung cancer screening among current smokers: data from health information national trends survey [published online April 25, 2019]. Cancer Epidemiol Biomarkers Prev. doi:10.1158/1055-9965.EPI-18-0629