Moffitt Cancer Center's Thoracic Oncology Program has compiled the following additional resources about lung cancer screening.
Research on Lung Cancer Screening Perceptions
Our team has conducted research to examine barriers and facilitators to LDCT from both the perspective of high-risk individuals and primary care providers. The abstracts are below and the full-text of the resulting articles are available at the corresponding links. The focus group guides used to conduct this work may also be accessed below. To find more about which patients are at high risk and recommended for annual lung cancer screening, view the Lung Screening Eligibility checklist.
If you are interested to learn more about the attitudes and perceptions regarding lung screening and how that might affect your practice, Moffitt is making these items available for you. Given potential geographic, cultural or language differences in your area, questions from these guides may be used as a starting point to determine if similar barriers exist among your population. We suggest adding culturally relevant questions specific to your population.
Findings and Publications
- Evaluation of Promotional Materials to Promote LDTC
Abstract: Low-dose computed tomography (LDCT) screening is a promising screening modality for increasing the detection rate of early stage lung cancers among high-risk individuals. Despite being recommended by the US Preventative Services Task Force, uptake of LDCT remains low. The objective of the current study was to gather feedback from high-risk consumers and health care providers on LDCT promotional materials. Focus group discussions were conducted with high-risk individuals (8 focus groups; N = 38) and primary care providers (9 focus groups; N = 23). Participants reviewed existing LDCT promotional materials to assess their perceptions of media materials created to publicize LDCT. Data were analyzed using the constant comparative method. Several key themes emerged from focus groups that can be used to inform development of future LDCT promotional materials. High-risk (HR) participants expressed greater receptivity for promotional materials that did not further stigmatize lung cancer and/or smoking and expressed preferences for materials that clearly outlined the risks/benefits of screening. Primary care providers (PCPs) offered suggestions to facilitate the referral process such as diagnostic codes and requested a design that clearly outlined eligibility criteria. A clear and thorough explanation of LDCT eligibility, cost, harms, and benefits was of chief importance for both PCP and HR audiences. Given that PCPs and HR audiences are not well informed on the specifics of LDCT screening eligibility and insurance coverage, creating provider and patient education opportunities will aid in shared decision-making opportunities. Promotional materials that meet the needs of the target audience are needed to facilitate discussions of risks/benefits of screening with HR individuals.
- High-Risk Community and Primary Care Providers’ Barriers and Facilitators
Abstract: Until recently, there has not been a valid and reliable screening test for lung cancer. As compared to chest X-ray, low-dose computed tomography (LDCT) lung cancer screening has demonstrated greater sensitivity resulting in lung cancer diagnosis at an earlier stage, thereby reducing lung cancer mortality among high-risk individuals by 20%. In the current study, we sought to examine knowledge and attitudes about LDCT screening for lung cancer among an ethnically and racially diverse sample of high risk (HR) community members and primary care providers (PCP).
Methods: Eligible individuals participated in a focus group using semi-structured interview guides. Focus groups were conducted with PCPs (by telephone) and HRs (in-person). Sessions were audio-taped and transcribed verbatim. The constant comparison method and content analysis were used to analyze results.
Results: The majority of PCPs had limited knowledge of lung cancer CT screening. PCPs cited barriers to recommendation including, cost/insurance barriers and the potential for false positives. PCPs perceived the main benefit to be early detection of lung cancer. The majority of HRs had never heard of lung LDCT screening and had never had a healthcare provider recommend it to them. Perceived barriers included fear of results (bad news) and financial costs. The main perceived benefit was early detection.
Conclusion: Lack of knowledge about LDCT was a key a barrier across both the PCP and HR. respondents. Understanding the barriers to lung screening across diverse community populations is necessary to improve screening rates and shared decision-making.
Focus Group Information (PDFs)
- [PDF] Lung Cancer Screening High Risk Focus Group Guide
- [PDF] Lung Cancer Screening Physician Focus Group Guide
- [PDF] Creative Brief - Lung Cancer Screening Focus Group Recommendations
- The Lung Cancer Alliance
- [PDF] American Lung Association® Lung Cancer Screening: Coverage in Health Insurance Plans (ALA)
- [PDF] National Comprehensive Cancer Network Guidelines for Patients® Lung Cancer Screening (NCCN)
- Lung Screening Eligibility
- Moffitt Cancer Center's Thoracic Oncology Program
This research was funded by an Infrastructure Grant from the Florida James and Esther King Biomedical Research Program.