A Qualitative Analysis of Lung Cancer Screening Practices by Primary Care Physicians
| Autor: | Susan Henderson, Elizabeth A. Rohan, Thomas B. Richards, Amy DeGroff, Cynthia Soloe, Christina L. Heminger, Julia Kish-Doto |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Lung Neoplasms Health (social science) Attitude of Health Personnel Decision Making MEDLINE Risk Assessment Physicians Primary Care Humans Medicine Practice Patterns Physicians' Lung cancer Early Detection of Cancer Qualitative Research Reimbursement business.industry Smoking Age Factors Public Health Environmental and Occupational Health Focus Groups medicine.disease Focus group United States Telephone Family medicine Practice Guidelines as Topic Female Radiography Thoracic Tomography X-Ray Computed business Risk assessment Lung cancer screening Qualitative research Patient education |
| Zdroj: | Journal of Community Health. 36:949-956 |
| ISSN: | 1573-3610 0094-5145 |
| DOI: | 10.1007/s10900-011-9394-2 |
| Popis: | Lung cancer is the leading cause of cancer death in the United States, but no scientific organization currently recommends screening because of limited evidence for its effectiveness. Despite this, physicians often order screening tests such as chest X-rays and computerized tomography scans for their patients. Limited information is available about how physicians decide when to order these tests. To identify factors that affect whether physicians' screen patients for lung cancer, we conducted five 75-min telephone-based focus groups with 28 US primary care physicians and used inductive qualitative research methods to analyze their responses. We identified seven factors that influenced these physicians' decisions about screening patients for lung cancer: (1) their perception of a screening test's effectiveness, (2) their attitude toward recommended screening guidelines, (3) their practice experience, (4) their perception of a patient's risk for lung cancer, (5) reimbursement and payment for screening, (6) their concern about litigation, and (7) whether a patient requested screening. Because these factors may have conflicting effects on physicians' decisions to order screening tests, physicians may struggle in determining when screening for lung cancer is appropriate. We recommend (1) more clinician education, beginning in medical school, about the existing evidence related to lung cancer screening, with emphasis on the benefit of and training in tobacco use prevention and cessation, (2) more patient education about the benefits and limitations of screening, (3) further studies about the effect of patients' requests to be screened on physicians' decisions to order screening tests, and (4) larger, quantitative studies to follow up on our formative data. |
| Databáze: | OpenAIRE |
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