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The Article in Brief
Lung Cancer Screening Practices of Primary Care Physicians: Results From a National Survey
Carrie N. Klabunde , and colleagues
Background Major expert groups do not recommend screening people without symptoms for lung cancer, including people with heavy or long-term smoking histories, because of a lack of strong evidence. This study examines US primary care physicians' self-reported lung cancer screening practices.
What This Study Found Primary care physicians in the United States frequently order lung cancer screening tests for asymptomatic patients. In a nationally representative survey of 962 primary care physicians, which used clinical vignettes to assess screening practices, 57 percent of respondents ordered at least one of three lung cancer screening tests (chest radiograph, low-radiation does spiral computed tomography, or sputum cytology) in the past 12 months for patients without symptoms. Thirty-eight percent reported ordering no tests. Physicians were more likely to order screening tests if they believed expert groups recommend lung cancer screening or that screening tests are effective; if they graduated from medical school 20 to 29 years ago; if they would recommend screening for asymptomatic patients, including patients without substantial smoking exposure; and if their patients had asked them about screening.
Implications
- To avoid inappropriate ordering, primary care physicians need more information about lung cancer screening's evidence base, guidelines, potential harms, and costs.