Eberth Jan M, Ersek Jennifer L, Terry Leah M, Bills Sarah E, Chintanippu Nirupama, Carlos Ruth, Hughes Danny R, Studts Jamie L
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; Director, Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
Levine Cancer Institute, Charlotte, North Carolina.
J Am Coll Radiol. 2020 Jul;17(7):960-969. doi: 10.1016/j.jacr.2020.02.001. Epub 2020 Feb 26.
Despite compelling support for the benefits of low-dose CT (LDCT) screening for lung cancer among high-risk individuals, awareness of LDCT screening and uptake remain low. The aim of this project was to explore the perspectives of ACR mammography screening program directors (MPDs) regarding efforts to raise LDCT screening awareness and appropriate referrals by identifying high-risk individuals participating in routine mammography.
MPDs were recruited from ACR-accredited mammography facilities to participate in semistructured interviews after the completion of an online survey. Interviews were conducted over the telephone, recorded, transcribed, and subsequently reviewed for accuracy. Twenty MPDs were interviewed, and 18 interviews were transcribed and included in the thematic analysis. A theme codebook was developed, and all interviews were coded using NVivo by two trained reviewers.
Key themes were organized into four broad domains: (1) general attitudes toward the integration of LDCT screening, (2) identifying mammography patients at high risk for lung cancer, (3) counseling about LDCT screening, and (4) strategies to identify high-risk women and increase awareness and knowledge of LDCT screening. Overall, MPDs recognized the benefits of integrating mammography and LDCT screening and were receptive to educating and referring women for LDCT screening. However, training and workflow changes are needed to ensure successful implementation.
Qualitative data suggest that MPDs are amenable to leveraging the mammography setting to engage women about LDCT screening; however, additional tools, training, and/or staffing may be necessary to leverage the full potential of reaching women at high risk for lung cancer within the context of mammographic screening.
尽管有令人信服的证据支持低剂量CT（LDCT）筛查对高危人群肺癌的益处，但LDCT筛查的知晓率和接受度仍然很低。本项目的目的是通过识别参与常规乳腺X线摄影的高危个体，探讨美国放射学会（ACR）乳腺X线摄影筛查项目主任（MPD）对提高LDCT筛查知晓率和进行适当转诊所做努力的看法。
在完成在线调查后，从ACR认可的乳腺X线摄影机构招募MPD参与半结构化访谈。访谈通过电话进行，录音、转录，随后进行准确性审查。共访谈了20名MPD，其中18份访谈记录被转录并纳入主题分析。制定了一个主题编码手册，由两名经过培训的评审员使用NVivo对所有访谈进行编码。
关键主题分为四个广泛领域：（1）对整合LDCT筛查的总体态度，（2）识别肺癌高危乳腺X线摄影患者，（3）关于LDCT筛查的咨询，（4）识别高危女性并提高对LDCT筛查的认识和知识的策略。总体而言，MPD认识到整合乳腺X线摄影和LDCT筛查的益处，并愿意为女性提供LDCT筛查的教育和转诊。然而，需要培训和工作流程的改变以确保成功实施。
定性数据表明，MPD愿意利用乳腺X线摄影环境让女性了解LDCT筛查；然而，可能需要额外的工具、培训和/或人员配置，以在乳腺X线摄影筛查的背景下充分发挥潜力，接触肺癌高危女性。
