Telephone-Based Shared Decision-making for Lung Cancer Screening in Primary Care

Area of Science:

• Oncology
• Public Health
• Health Services Research

Background:

• The national lung cancer screening rate is critically low (3-5%), highlighting the need for effective interventions.
• Shared decision-making (SDM) and increased screening are crucial for early lung cancer detection.
• USPSTF guidelines identify eligible candidates for lung cancer screening.

Purpose of the Study:

• To assess the feasibility and effectiveness of a telephone-based SDM intervention for lung cancer screening.
• To evaluate the impact of the Decision Counseling Program (DCP) on screening completion rates.
• To explore patient demographics and factors influencing participation and screening completion.

Main Methods:

• A feasibility study conducted in a large primary care practice.
• Telephone-based delivery of decision support using the Decision Counseling Program (DCP©).
• Data collection included demographics, decisional conflict, and chart audits for screening ascertainment; 829 age-eligible smokers were identified.

Main Results:

• 20 participants completed the DCP intervention; those in the intervention were more likely to complete low-dose CT scans at 90 days.
• Current smokers were less likely to complete the DCP intervention.
• Women were less likely to complete low-dose CT scans (LDCT).

Conclusions:

• This non-persuasive, high-quality SDM intervention significantly increased lung cancer screening.
• The telephone-based DCP is a feasible model for real-world clinical care.
• The intervention supports patients in making informed decisions aligned with their values, improving screening uptake.