Referrals for Lung Cancer CT Imaging Screening Remain Low Among Family Physicians

Most family physicians report discussing low-dose CT imaging with patients at high risk for lung cancer, but referrals for screening remain low, a study published in the journal Cancer has shown.1

The National Lung Cancer Screening Trial demonstrated a 20% reduction in lung cancer mortality and a 6.7% reduction in all-cause mortality when high-risk patients were screened with low-dose CT vs chest radiography. The US Preventive Services Task Force has issued a grade B recommendation for low-dose CT screening, and the Centers for Medicare and Medicaid Services and private insurers now cover the cost of screening for certain conditions.

Therefore, researchers sought to evaluate the knowledge of, attitudes towards, and the use of low-dose CT screening for lung cancer among family physicians. For the study, 101 family physicians in South Carolina completed a 32-item questionnaire.

Results showed that most physicians had incorrect knowledge about which organizations recommend screening. Further, researchers found that many physicians continued to recommend chest radiography for lung cancer screening despite the results of the National Lung Cancer Screening Trial and the recommendation by the US Preventive Services Task Force.

Most physicians reported feeling that low-dose CT screening improved the likelihood of detecting lung cancer at earlier stages and that the benefits outweighed the harms. Concerns about low-dose CT screening included unnecessary procedures (88%), stress/anxiety (52%), and radiation exposure (50%).

The study also demonstrated that approximately three-fourths of physicians discussed the risks and benefits of screening with their patients in some capacity; however, more than half reported making no or 1 screening recommendations in the last year.

"There are gaps in physician knowledge about screening guidelines and reimbursement, and this indicates a need for further educational outreach," the authors conclude. "The development of decision aids may facilitate shared decision-making discussions about screening, and targeted interventions may improve knowledge gaps."


1. Ersek JL, Eberth JM, McDonnell KK, et al. Knowledge of, attitudes toward, and use of low-dose computed tomography for lung cancer screening among family physicians [published online June 13, 2016]. Cancer. doi: 10.1002/cncr.29944.

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