Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
Curtin Medical School, Curtin University, Perth, Western Australia, Australia.
Intern Med J. 2021 Jul;51(7):1111-1116. doi: 10.1111/imj.14838.
Low-dose computed tomography (LDCT) screening can reduce lung cancer deaths in high-risk individuals, yet current Australian guidelines do not recommend screening. Little is known about current screening practices in Australia.
To evaluate the proportion of general practitioners who report ordering lung cancer screening for their patients, identify factors associated with ordering lung cancer screening and assess general practitioners (GP) rationale for recommending screening and preference of composition of any future national targeted screening programme.
A survey was distributed to a nationally representative sample of 4000 Australian GP. The questionnaire included respondent demographics, self-reported screening practices, knowledge of screening recommendations, recent screening education, preference for recruitment methodologies for potential screening programmes and potential factors influencing the screening practices of GP. Two logistic regression models identified factors associated with self-reported chest X-ray (CXR) and LDCT screening within the past 12 months.
A total of 323 GP completed the survey (participation rate 8.1%). Participants were mostly females (50.6%), from collective/group (79.1%) and metropolitan-based practices (73.5%). Despite the majority of responders understanding that screening is not recommended by Australian professional societies (71.2%), a substantial proportion of participants requested a CXR or LDCT screening (46.4% and 20.8% respectively). A variety of shared (GP reassurance, affordability of screening, believing screening is funded) and unique practice, educational and cognitive factors were associated with self-reported LDCT and CXR screening, with the strongest association being recent education about screening from radiology practices (odds ratio (aOR) for LDCT screening 10.4, P < 0.001).
In Australia, lung cancer screening occurs outside a coordinated programme, and there is discordance between practice and national recommendations. This highlights an urgent need for clearer guidance from national and professional bodies.
低剂量计算机断层扫描（LDCT）筛查可降低高危人群的肺癌死亡率，但目前澳大利亚的指南不建议进行筛查。目前对澳大利亚的筛查实践知之甚少。
评估报告为患者进行肺癌筛查的全科医生比例，确定与进行肺癌筛查相关的因素，并评估全科医生（GP）推荐筛查的理由以及对任何未来国家靶向筛查计划组成的偏好。
向 4000 名澳大利亚全科医生进行了一项全国代表性样本调查。问卷包括受访者的人口统计学特征、自我报告的筛查实践、对筛查建议的了解、最近的筛查教育、对潜在筛查计划的招聘方法的偏好以及可能影响 GP 筛查实践的潜在因素。使用两个逻辑回归模型确定了与过去 12 个月内自我报告的胸部 X 光（CXR）和 LDCT 筛查相关的因素。
共有 323 名 GP 完成了调查（参与率为 8.1%）。参与者大多为女性（50.6%），来自集体/团体（79.1%）和大都市区的实践（73.5%）。尽管大多数应答者了解到澳大利亚专业协会不推荐筛查（71.2%），但仍有相当一部分参与者要求进行 CXR 或 LDCT 筛查（分别为 46.4%和 20.8%）。各种共享（GP 保证、筛查的负担能力、相信筛查是由资金资助的）和独特的实践、教育和认知因素与自我报告的 LDCT 和 CXR 筛查相关，与最近从放射科实践接受的筛查教育的关联最强（LDCT 筛查的优势比[aOR]为 10.4，P <0.001）。
在澳大利亚，肺癌筛查是在协调的计划之外进行的，并且实践与国家建议之间存在不一致。这突显了国家和专业机构提供更明确指导的迫切需要。
