An Analysis of Lung Cancer Screening Beliefs and Practice Patterns for Community Providers Compared to Academic Providers. (29th October 2018)

• Record Type: Journal Article
• Authors: Khairy, Marjon; Duong, Duy K.; Shariff-Marco, Salma; Cheng, Iona; Jain, Jennifer; Balakrishnan, Anupama; Liu, Lynn; Gupta, Aarti; Chandramouli, Ranjani; Hsing, Ann; Leung, Ann; Singh, Baldeep; Nair, Viswam S.
• Is Part Of: Cancer control. Volume 25:Number 1(2018)
• Publication Date: 2018-10-29
• Subjects: lung cancer -- cancer detection -- cancer screening -- computed tomography -- early diagnosis; Cancer -- Prevention -- Periodicals; Cancer -- Diagnosis -- Periodicals; Cancer -- Treatment -- Periodicals; Cancer -- Palliative treatment -- Periodicals; Cancer -- Prevention; Medical Oncology; Neoplasms -- prevention & control; Neoplasms -- therapy; Electronic journals; Periodicals; Periodicals; 616.994005
• DOI: 10.1177/1073274818806900
• Languages: English
• ISSNs: 1073-2748

Abstract

Despite guidelines recommending annual low-dose computed tomography (LDCT) screening for lung cancer, uptake remains low due to the perceived complexity of initiating and maintaining a clinical program—problems that likely magnify in underserved populations. We conducted a survey of community providers at Federally Qualified Health Centers (FQHCs) in Santa Clara County, California, to evaluate provider-related factors that affect adherence. We then compared these findings to academic providers' (APs) LDCT screening knowledge, behaviors, and attitudes at an academic referral center in the same county. The 4 FQHCs enrolled care for 80 000 patients largely of minority descent and insured by Medi-Cal. Of the 75 FQHC providers (FQHCPs), 36 (48%) completed the survey. Of the 36 providers, 8 (22%) knew screening criteria. Fifteen (42%) FQHCPs discussed LDCT screening with patients. Compared to 36 APs, FQHCPs were more concerned about harms, false positives, discussion time, patient apathy, insurance coverage, and a lack of expertise for screening and follow-up. Yet, more FQHCPs thought screening was effective (27 [75%] of 36) compared to APs ( P = .0003). In conclusion, provider knowledge gaps are greater and barriers are different for community clinics caring for underserved populations compared to their academic counterparts, but practical and scalable solutions exist to enhance adoption.