Shin Dong Wook, Chun Sohyun, Kim Young Il, Kim Seung Joon, Kim Jung Soo, Chong SeMin, Park Young Sik, Song Sang-Yun, Lee Jin Han, Ahn Hee Kyung, Kim Eun Young, Yang Sei Hoon, Lee Myoung Kyu, Cho Deog Gon, Jang Tae Won, Son Ji Woong, Ryu Jeong-Seon, Cho Moon-June
Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Department of digital health, SAIHST, Sungkyunkwan University, Seoul, Korea.
International Clinic, Samsung Medical Center, Seoul, Korea.
PLoS One. 2018 Feb 8;13(2):e0192626. doi: 10.1371/journal.pone.0192626. eCollection 2018.
Lung cancer specialists play an important role in designing and implementing lung cancer screening. We aimed to describe their 1) attitudes toward low-dose lung computed tomography (LDCT) screening, 2) current practices and experiences of LDCT screening and 3) attitudes and opinions towards national lung cancer screening program (NLCSP). We conducted a national web-based survey of pulmonologists, thoracic surgeons, medical oncologists, and radiological oncologists who are members of Korean Association for Lung Cancer (N = 183). Almost all respondents agreed that LDCT screening increases early detection (100%), improves survival (95.1%), and gives a good smoking cessation counseling opportunity (88.6%). Most were concerned about its high false positive results (79.8%) and the subsequent negative effects. Less than half were concerned about radiation hazard (37.2%). Overall, most (89.1%) believed that the benefits outweigh the risks and harms. Most (79.2%) stated that they proactively recommend LDCT screening to those who are eligible for the current guidelines, but the screening propensity varied considerably. The majority (77.6%) agreed with the idea of NLCSP and its beneficial effect, but had concerns about the quality control of CT devices (74.9%), quality assurance of radiologic interpretation (63.3%), poor access to LDCT (56.3%), and difficulties in selecting eligible population using self-report history (66.7%). Most (79.2%) thought that program need to be funded by a specialized fund rather than by the National Health Insurance. The opinions on the level of copayment for screening varied. Our findings would be an important source for health policy decision when considering for NLCSP in Korea.
肺癌专家在设计和实施肺癌筛查中发挥着重要作用。我们旨在描述他们1)对低剂量肺部计算机断层扫描(LDCT)筛查的态度,2)LDCT筛查的当前实践和经验,以及3)对国家肺癌筛查计划(NLCSP)的态度和意见。我们对韩国肺癌协会成员中的肺科医生、胸外科医生、医学肿瘤学家和放射肿瘤学家进行了一项全国性的网络调查(N = 183)。几乎所有受访者都认为LDCT筛查能提高早期发现率(100%)、改善生存率(95.1%),并提供良好的戒烟咨询机会(88.6%)。大多数人担心其高假阳性结果(79.8%)及后续负面影响。不到一半的人担心辐射危害(37.2%)。总体而言,大多数人(89.1%)认为益处大于风险和危害。大多数人(79.2%)表示他们会主动向符合现行指南的人推荐LDCT筛查,但筛查倾向差异很大。大多数人(77.6%)同意NLCSP及其有益效果,但对CT设备的质量控制(74.9%)、放射学解读的质量保证(63.3%)、LDCT获取不便(56.3%)以及使用自我报告病史选择合格人群的困难(66.7%)表示担忧。大多数人(79.2%)认为该计划需要由专项基金而非国家健康保险提供资金。关于筛查自付费用水平的意见各不相同。我们的研究结果将是韩国在考虑NLCSP时卫生政策决策的重要依据。