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Arnold School of Public Health


Eberth and team find family physicians may have knowledge gaps re: lung cancer screening

June 28, 2016 | Erin Bluvas, bluvase@sc.edu 

Epidemiology and Biostatistics Assistant Professor Jan Eberth and an interdisciplinary group of researchers* recently published findings from a study in Cancer, a journal of the American Cancer Society, that may cause concern for those at risk of developing lung cancer. Their paper, “Knowledge of, attitudes toward, and use of low-dose computed tomography for lung cancer screening among family physicians,” presented findings from the team’s 2015 research, which suggest physicians may have inaccurate knowledge about lung cancer screening recommendations.

The authors’ study surveyed 101 South Carolina-based family physicians to assess their awareness related to current recommendations on cancer screening for high-risk patients (e.g., former smokers and current smokers with 30+ pack years smoking history), as well as how likely they were to recommend lung cancer screening for their high-risk patients. Despite evidence from clinical trials that links lung cancer screening to reduced lung cancer mortality, less than half of the survey respondents indicated this was a benefit of screening. The majority of participants were also unaware of current recommendations by organizations, such as the United States Preventive Services Task Force and the Centers for Medicare and Medicaid Services (though other groups remain undecided), for screening high-risk patients. Despite these knowledge gaps, most physicians surveyed felt the benefits of screening outweigh the risks and reported having five or more patients inquire about screening in the past year.

Education is needed to bridge these knowledge gaps and lay a foundation on which physicians can base their treatment recommendations.

-Jan Eberth, Assistant Professor of Epidemiology and Biostatistics

With lung cancer leading all cancers as the number one cause of cancer-related mortality in the United States, it is important that family physicians know the most current screening recommendations and understand the risks and benefits of low-dose computed tomography (CT) screening for people with different risk profiles.

“Education is needed to bridge these knowledge gaps and lay a foundation on which physicians can base their treatment recommendations,” says Eberth, who is a core faculty member of the Cancer Prevention and Control Program and the Deputy Director of the South Carolina Rural Health Research Center. “With the Centers for Medicare and Medicaid Services now offering reimbursement to primary care providers to engage in shared decision making with their patients about lung cancer screening, it is vital that providers have an accurate understanding of the eligibility criteria for screening and potential risks and benefits. Decision aids may be a useful tool to facilitate these treatment discussions.”

Since Eberth’s study was conducted in 2015, several new decision aids have become available for primary care physicians to utilize during counseling visits with their patients, including several endorsed by the Agency for Healthcare Research and Quality.

While efforts to give physicians and patients tools to expand their knowledge of lung cancer screening continue to grow, the findings from this study are already reaching patients directly, thanks to a press release from the Cancer team. So far, a variety of media outlets (e.g., Fox News, The Globe and Mail, UPI, ScienceDaily, Yahoo) have disseminated the findings—putting knowledge into the hands of patients who may be interested in discussing low-dose CT screening with their primary care physician.

*Jennifer L. Ersek (Epidemiology and Biostatistics), Karen Kane McDonnell (College of Nursing, USC), Scott M. Strayer (School of Medicine), Erica Sercy (Cancer Prevention and Control Program), Kathleen B. Cartmell (College of Nursing, MUSC), Daniela B. Friedman (Health Promotion, Education, and Behavior)