Survey Finds Rates of Physician-Patient Discussions About Lung Cancer Screening Are Declining
A study examining trends in patient-reported physician-patient discussions about lung cancer screening and the association of these discussions with smokers’ attempts to quit and intent to quit has found that discussions about screening have declined since 2012. Moreover, they were not associated with current smokers’ intents or attempts to quit smoking. These findings were published by Huo et al in Cancer Epidemiology, Biomarkers & Prevention.
Lung cancer is the leading cause of cancer-related death in both men and women in the United States. According to the American Cancer Society, in 2019, over 228,000 people will be diagnosed with lung cancer, and over 142,000 will die from their disease.
Since 2011, three events have supported the benefit of lung cancer screening: in 2011, the National Lung Screening Trial demonstrated that low-dose computed tomography reduced lung cancer-related mortality by 20% compared with chest x-ray; in 2013, the U.S. Preventive Services Task Force issued a recommendation for lung cancer screening; and in 2015, the Centers for Medicare & Medicaid Services released a lung cancer screening policy.
Study Methodology
The researchers analyzed data from the National Cancer Institute’s Health Information National Trends Survey (HINTS), a nationwide, population-based telephone survey that collects cancer-related information on health technology and communication, in 2012, 2014, and 2017. The target population of HINTS is adults aged 18 years and older.
The survey included questions on whether respondents had talked with their physicians about having a test to check for lung cancer in the past year and their smoking status. Respondents were also asked two questions to measure smokers’ intent to quit smoking and their attempt to quit smoking. The researchers analyzed the prevalence of physician-patient discussions about lung cancer screening by age group, smoking status, insurance coverage, and ethnicity.
Current smokers were defined as people who had smoked at least 100 cigarettes in their lifetime and were smoking cigarettes every day or some days at the time of the survey; former smokers were defined as those who had smoked previously but did not smoke at the time of the survey; and never-smokers were defined as those who had smoked no cigarettes or less than 100 over their lifetime. Using logistic regression, the researchers estimated the probability of smokers’ attempt to quit and intention to quit.
Study Results
Among 9,443 individuals surveyed, the crude estimated rates of physician-patient discussion decreased from 6.7% in 2012 to 4.2% in 2014 and 4.3% in 2017. Across the age and smoking status groups, the current smokers aged 55 to 74 in 2012 (26.8%) and current smokers older than 74 in 2014 (23.5%) and 2017 (22.1%) had the highest rates of discussion. Among current smokers, non-Hispanic Blacks, Hispanics, patients covered by insurance, and those diagnosed with heart or lung disease were more likely to have engaged in discussions with physicians.
Multivariable analysis determined that discussion about lung cancer screening was not associated with current smokers’ intention to quit smoking in the next 6 months or their attempts to quit in the past year. “Efforts are needed to improve the physician-patient discussion about lung cancer screening among individuals across a spectrum of lung cancer risk,” concluded the study authors.
Health Impact
According to the study authors, “Developing communication strategies for promoting beneficial lung cancer screening among lung cancer screening–eligible smokers and strategies for improving the quality of discussion on lung cancer screening integrating smoking cessation are needed to reduce the burden of lung cancer.”
Jinhai Huo, MD, PhD, MSPH, of the University of Florida in Gainesville, is the corresponding author of this study.
Disclosure: Funding for this study was provided by the University of Florida Health Cancer Center Research Pilot Grant. For full disclosures of the study authors, visit cebp.aacrjournals.org.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
