Lisa Carter-Harris1, Andy S L Tan2, Ramzi G Salloum3, Kelly C Young-Wolff4. 1. Indiana University School of Nursing, Indianapolis, IN, USA. Electronic address: lcharris@iu.edu. 2. Department of Social and Behavioral Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. 3. Department of Health Outcomes and Policy, and Institute for Child Health Policy, University of Florida College of Medicine, Gainesville, FL, USA. 4. Kaiser Permanente Northern California Division of Research, Oakland, CA, USA.
Abstract
OBJECTIVE: In 2013, the USPSTF issued a Grade B recommendation that long-term current and former smokers receive lung cancer screening. Shared decision-making is important for individuals considering screening, and patient-provider discussions an essential component of the process. We examined prevalence and predictors of lung cancer screening discussions pre- and post-USPSTF guidelines. METHODS: Data were obtained from two cycles of the Health Information National Trends Survey (2012; 2014). The analyzed sample comprised screening-eligible current and former smokers with no personal history of lung cancer (n=746 in 2012; n=795 in 2014). Descriptive and multiple logistic regression analyses were conducted; patient-reported discussion about lung cancer screening with provider was the outcome of interest. RESULTS: Contrary to expectations, patient-provider discussions about lung cancer screening were more prevalent pre-guideline, but overall patient-provider discussions were low in both years (17% in 2012; 10% in 2014). Current smokers were more likely to have had a discussion than former smokers. Significant predictors of patient-provider discussions included family history of cancer and having healthcare coverage. CONCLUSIONS: The prevalence of patient-provider discussions about lung cancer screening is suboptimal. PRACTICE IMPLICATIONS: There is a critical need for patient and provider education about shared decision-making and its importance in cancer screening decisions.
OBJECTIVE: In 2013, the USPSTF issued a Grade B recommendation that long-term current and former smokers receive lung cancer screening. Shared decision-making is important for individuals considering screening, and patient-provider discussions an essential component of the process. We examined prevalence and predictors of lung cancer screening discussions pre- and post-USPSTF guidelines. METHODS: Data were obtained from two cycles of the Health Information National Trends Survey (2012; 2014). The analyzed sample comprised screening-eligible current and former smokers with no personal history of lung cancer (n=746 in 2012; n=795 in 2014). Descriptive and multiple logistic regression analyses were conducted; patient-reported discussion about lung cancer screening with provider was the outcome of interest. RESULTS: Contrary to expectations, patient-provider discussions about lung cancer screening were more prevalent pre-guideline, but overall patient-provider discussions were low in both years (17% in 2012; 10% in 2014). Current smokers were more likely to have had a discussion than former smokers. Significant predictors of patient-provider discussions included family history of cancer and having healthcare coverage. CONCLUSIONS: The prevalence of patient-provider discussions about lung cancer screening is suboptimal. PRACTICE IMPLICATIONS: There is a critical need for patient and provider education about shared decision-making and its importance in cancer screening decisions.
Keywords:
HINTS; Health Information National Trends Survey; Health communication; Lung cancer screening; Patient-provider discussion; Shared decision making
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