Primary Care Provider and Patient Perspectives on Lung Cancer Screening. A Qualitative Study

作者：Neeti M. Kanodra, Charlene A. Pope, Chanita Hughes Halbert, Gerard A. Silvestri, LaShanta J. Rice, Nichole T. Tanner · 发表于：Annals of the American Thoracic Society · 年份：2016 · DOI：10.1513/annalsats.201604-286oc · 被引用次数：133 · 研究领域：Lung Cancer Diagnosis and Treatment、Global Cancer Incidence and Screening、Lung Cancer Treatments and Mutations

RATIONALE: The U.S. Preventive Services Task Force recommends annual low-dose computed tomography (LDCT) for lung cancer screening in high-risk individuals. Preventive healthcare is provided predominantly by primary care providers (PCPs). Successful implementation of a screening program requires acceptance and participation by both providers and patients, with available collaboration with pulmonologists. OBJECTIVES: To identify perceptions of and perspectives on lung cancer screening and implementation among PCPs and eligible veteran patients at high risk for lung cancer. METHODS: We conducted a qualitative study using grounded theory in which 28 veterans and 13 PCPs completed a questionnaire and participated in focus groups. Sessions were recorded, transcribed verbatim, and analyzed with NVivo 10 software. Counts and percentages were used to report questionnaire results. MEASUREMENTS AND MAIN RESULTS: While 58% percent of providers were aware of lung cancer screening guidelines, many could not recall the exact patient eligibility criteria. Most patients were willing to undergo LDCT screening and identified smoking as a risk factor for lung cancer, but they did not recall their PCP explaining the reason for the testing. All providers assessed smoking behavior, but only 23% referred active smokers for formal cessation services. Patients volunteered information regarding their hurdles with smoking cessation while discussing risk factors for cancer. PCPs cited time constraints a...