Physicians' knowledge and practice of lung cancer screening: a cross-sectional survey comparing general practitioners, thoracic oncologists, and pulmonologists in France.

BACKGROUND

Screening for lung cancer by low-dose computed tomography scan (LDCTS) has been demonstrated to reduce lung cancer-specific and overall mortality rates in high-risk individuals. From trial to clinical practice, it is crucial to obtain an accurate level of knowledge of the physicians who will recruit patients for a screening program. The actual current practice and knowledge of practitioners are unknown. This could be critical to develop dedicated continuous medical education programs.

MATERIALS AND METHODS

Three groups of French physicians--pulmonologists (PUs), thoracic oncologists (TOs), and general practitioners (GPs)--were surveyed through a dedicated questionnaire on lung cancer screening.

RESULTS

A total of 242 physicians answered the questionnaire; 81% of TOs knew that LDCTS showed efficacy for screening lung cancer compared with 52% of PUs and 18% of GPs (P < .0001). Approximately one third of physicians recommended lung cancer screening in daily practice at the time of the survey, including 53% of PUs, 34% of TOs, and 20% of GPs (P < .001). However, 94% of GPs, 44% of PUs, and 33% of TOs used inappropriate tests, mainly chest radiography. Most GPs proposed screening for all smokers, whereas PUs and TOs reserved screening for heavy smokers (P = .040). Most PUs and TOs recommended annual LDCTS (76%), whereas the majority of GPs sent patients for screening tests every 3 to 5 years (93%; P < .0001).

CONCLUSIONS

These results highlight the interest of physicians for lung cancer screening; meanwhile, our data stress the need for appropriate medical education and recommendations based on available evidence.