Wong Lye-Yeng, Choudhary Sania, Kapula Ntemena, Lin Margaret, Elliott Irmina A, Guenthart Brandon A, Liou Douglas Z, Backhus Leah M, Berry Mark F, Shrager Joseph B, Lui Natalie S
Department of Cardiothoracic Surgery, Stanford University School of Medicine, 300 Pasteur Drive, Falk Building, Stanford, CA 94305.
Department of Radiology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305.
Clin Lung Cancer. 2024 Jul;25(5):424-430. doi: 10.1016/j.cllc.2024.04.014. Epub 2024 Apr 27.
Annual low-dose computed tomography (LDCT) screening has been shown to reduce lung cancer mortality in high-risk individuals by detecting the disease at an earlier stage. This study aims to assess the barriers to completing LDCT in a cohort of patients who were determined eligible for lung cancer screening (LCS).
We performed a single institution, mixed methods, cross-sectional study of patients who had a LDCT ordered from July to December 2022. We then completed phone surveys with patients who did not complete LDCT to assess knowledge, attitude, and perceptions toward LCS.
We identified 380 patients who met inclusion criteria, including 331 (87%) who completed LDCT and 49 (13%) who did not. Patients who completed a LDCT and those who did not were similar regarding age, sex, race, primary language, household income, body mass index, median pack years, and quit time. Positive predictors of LDCT completion were: meeting USPSTF guidelines (97.9% vs 81.6%), being married (58.3% vs 44.9%), former versus current smokers (55% vs 41.7%), personal history of emphysema (60.4% vs 42.9%), and family history of lung cancer (13.9% vs 4.1%) (all P < .05). Of the patients who participated in the phone survey, only 7% of respondents thought they were high risk for developing lung cancer despite attending a shared decision-making visit and only 10% wanted to re-schedule their LDCT.
There exist barriers to completing LDCT even after patients are identified as eligible and complete a shared decision-making visit secondary to knowledge barriers, misperceptions, and patient disinterest.
年度低剂量计算机断层扫描（LDCT）筛查已被证明可通过在早期阶段检测疾病来降低高危个体的肺癌死亡率。本研究旨在评估一组被确定符合肺癌筛查（LCS）条件的患者完成LDCT的障碍。
我们对2022年7月至12月接受LDCT检查的患者进行了一项单机构、混合方法的横断面研究。然后，我们对未完成LDCT的患者进行了电话调查以评估他们对LCS的知识、态度和认知。
我们确定了380名符合纳入标准的患者，其中331名（87%）完成了LDCT，49名（13%）未完成。完成LDCT的患者和未完成的患者在年龄、性别、种族、主要语言、家庭收入、体重指数、中位吸烟包年数和戒烟时间方面相似。LDCT完成的积极预测因素包括：符合美国预防服务工作组（USPSTF）指南（97.9%对81.6%）、已婚（58.3%对44.9%）、既往吸烟者与当前吸烟者（55%对41.7%）、肺气肿个人史（60.4%对42.9%）以及肺癌家族史（13.9%对4.1%）（所有P<.05）。在参与电话调查的患者中，尽管参加了共同决策就诊，但只有7%的受访者认为自己患肺癌的风险很高，只有10%的人想重新安排他们的LDCT检查。
即使在患者被确定符合条件并完成共同决策就诊后，由于知识障碍、误解和患者缺乏兴趣，完成LDCT仍存在障碍。
