Navigating the Complexity of Lung Cancer Surveillance Practices: Qualitative Pilot Study on Provider Perspectives

Area of Science:

• Oncology
• Medical Informatics
• Qualitative Research

Background:

• Lung cancer survivorship surveillance is crucial for detecting recurrence and second primary lung cancer (SPLC) early.
• Current surveillance guidelines are controversial, lacking defined and consistently applied provider decision-making factors.

Purpose of the Study:

• To understand factors influencing lung cancer surveillance practices.
• To explore provider perspectives on using risk stratification tools for surveillance.

Main Methods:

• Conducted semistructured interviews with 13 US-based lung cancer providers (physicians and advanced practice providers).
• Utilized qualitative inductive content analysis to identify themes from transcribed interviews.
• Providers were recruited from Palo Alto Veterans Affairs Medical Center and Stanford Medicine.

Main Results:

• Identified 3 key themes regarding current surveillance and risk stratification tools.
• Theme 1: Clinicians consider diverse clinical and nonclinical factors in decision-making.
• Theme 2: Providers expressed concerns about the generalizability, accuracy, and validity of risk stratification tools.
• Theme 3: Concerns exist regarding patient anxiety, misinterpretation, and adherence when delivering risk stratification data.

Conclusions:

• Lung cancer surveillance decision-making is complex, with provider concerns about tool accuracy and data delivery.
• Further development of risk stratification tools must address data quality, accuracy across diverse factors, and effective patient communication.
• Improved tools can enhance the practical implementation for better SPLC and recurrence surveillance.