Japuntich Sandra J, Sacasa Nathalia Gutierrez, Cameron Sarah, Balletto Brittany, Tambou Olive, Berman Gabriel, Walaska Kristen, Clark Melissa A, Carey Michael P, Busch Andrew M, Rosen Rochelle
Hennepin Healthcare Research Institute, 701 Park Ave., S9.303, Minneapolis, MN, 55415, USA.
Department of Medicine, University of Minnesota Medical School, 420 Delaware St. SE, Minneapolis, MN, 55455, USA.
BMC Cancer. 2025 Aug 11;25(1):1305. doi: 10.1186/s12885-025-14716-6.
Lung cancer screening (LCS) with low dose CT can identify early-stage lung cancer and reduce lung cancer mortality. LCS is underutilized. Patient and provider concerns and experiences may contribute to low utilization.
To categorize patient and provider experiences with lung cancer screening to identify barriers to utilization.
Mixed methods study with a survey plus a qualitative interview.
Participants were 50 patients aged 55-80 with a smoking history and 7 primary care physicians in the United States.
Participants were interviewed about LCS perceptions and experiences. Transcripts were double-coded and an Applied Thematic Analysis identified key themes.
Thirty-two patients (68% of those with valid data) met US Preventive Services Taskforce guideline criteria for lung cancer screening, 11 (22%) self-reported tests consistent with LCS. Five main themes emerged: (1) Patient knowledge about LCS is low, even among those screened. Provider knowledge is high. (2) Low dose CT for LCS is well tolerated by patients and acceptable to providers. (3) Provider behavior is influenced by public health guidelines but not insurance coverage. (4) Shared decision-making is not always engaged in. (5) System barriers in the referral process affect LCS receipt despite patient interest in LCS.
LCS is well tolerated by patients and valued by providers. To increase LCS knowledge and uptake, systems changes are needed to facilitate shared decision-making conversations, simplify the referral process, and provide care navigation to increase patient logistical barriers to uptake.
低剂量CT肺癌筛查（LCS）可识别早期肺癌并降低肺癌死亡率。LCS的利用率较低。患者和医疗服务提供者的担忧及经历可能导致利用率低下。
对肺癌筛查中患者和医疗服务提供者的经历进行分类，以确定利用率的障碍。
采用调查加定性访谈的混合方法研究。
参与者为美国50名年龄在55 - 80岁且有吸烟史的患者和7名初级保健医生。
就LCS的认知和经历对参与者进行访谈。对访谈记录进行双重编码，并通过应用主题分析确定关键主题。
32名患者（占有效数据患者的68%）符合美国预防服务工作组肺癌筛查指南标准，11名（22%）自我报告的检测符合LCS。出现了五个主要主题：（1）患者对LCS的了解程度较低，即使是在接受筛查的患者中也是如此。医疗服务提供者的了解程度较高。（2）患者对用于LCS的低剂量CT耐受性良好，医疗服务提供者也认可。（3）医疗服务提供者的行为受公共卫生指南影响，但不受保险覆盖范围影响。（4）并非总是进行共同决策。（5）尽管患者对LCS感兴趣，但转诊过程中的系统障碍影响了LCS的接受情况。
患者对LCS耐受性良好，医疗服务提供者重视LCS。为了提高对LCS的了解和接受程度，需要进行系统变革，以促进共同决策对话，简化转诊流程，并提供护理导航，以减少患者接受筛查的后勤障碍。
