Attitudes About Lung Cancer Screening: Primary Care Providers Versus Specialists

On the basis of the results of the National Lung Screening Trial, the US Preventive Services Task Force now recommends yearly low-dose computed tomography (LDCT) for lung cancer screening among high-risk individuals. There is limited information regarding physician attitudes toward LDCT screening and whether these vary according to provider specialty.

Primary care providers (PCPs) and specialists were surveyed about their knowledge and attitudes toward lung cancer screening and likelihood to order an LDCT screening. Descriptive and univariate analyses were used to assess differences between PCPs versus specialists.

Of the 103 respondents 69% were PCPs, 45% were attending-level physicians, 42% were male, and most (51%) worked in mixed outpatient/inpatient practice settings. Compared with specialists, PCPs were less likely to feel confident in their ability to identify appropriate patients for lung cancer screening (63.8% vs. 93.5%; P < .01) or to decide the workup of patients with positive LDCT findings (52.9% vs. 93.5%; P < .01). PCPs were also less likely to believe that the recommended yearly screening interval is feasible (27.5% vs. 86.7%; P < .01), to feel comfortable counseling patients on LDCT (51.4% vs. 82.8%; P = .01) or have sufficient time for counseling (14.3% vs. 50%; P < .01). Despite these differences, PCPs were equally as likely as specialists to recommend LDCT for their high-risk smokers.

Despite feeling less confident and knowledgeable about lung cancer screening, PCPs are as likely as specialists to recommend LDCT screening. However, PCPs need further education to ensure the success of lung cancer screening programs.