Attitudes and Beliefs of Primary Care Providers in New Mexico About Lung Cancer Screening Using Low-Dose Computed Tomography

Richard M Hoffman; Andrew L Sussman; Christina M Getrich; Robert L Rhyne; Richard E Crowell; Kathryn L Taylor; Ellen J Reifler; Pamela H Wescott; Ambroshia M Murrietta; Ali I Saeed; Shiraz I Mishra

doi:10.5888/pcd12.150112

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Attitudes and Beliefs of Primary Care Providers in New Mexico About Lung Cancer Screening Using Low-Dose Computed Tomography

Journal article

Open access

Attitudes and Beliefs of Primary Care Providers in New Mexico About Lung Cancer Screening Using Low-Dose Computed Tomography

Richard M Hoffman, Andrew L Sussman, Christina M Getrich, Robert L Rhyne, Richard E Crowell, Kathryn L Taylor, Ellen J Reifler, Pamela H Wescott, Ambroshia M Murrietta, Ali I Saeed, …

Preventing chronic disease, Vol.12(7), pp.E108-E108

07/09/2015

DOI: 10.5888/pcd12.150112

PMCID: PMC4509091

PMID: 26160294

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Abstract

On the basis of results from the National Lung Screening Trial (NLST), national guidelines now recommend using low-dose computed tomography (LDCT) to screen high-risk smokers for lung cancer. Our study objective was to characterize the knowledge, attitudes, and beliefs of primary care providers about implementing LDCT screening. We conducted semistructured interviews with primary care providers practicing in New Mexico clinics for underserved minority populations. The interviews, conducted from February through September 2014, focused on providers' tobacco cessation efforts, lung cancer screening practices, perceptions of NLST and screening guidelines, and attitudes about informed decision making for cancer screening. Investigators iteratively reviewed transcripts to create a coding structure. We reached thematic saturation after interviewing 10 providers practicing in 6 urban and 4 rural settings; 8 practiced at federally qualified health centers. All 10 providers promoted smoking cessation, some screened with chest x-rays, and none screened with LDCT. Not all were aware of NLST results or current guideline recommendations. Providers viewed study results skeptically, particularly the 95% false-positive rate, the need to screen 320 patients to prevent 1 lung cancer death, and the small proportion of minority participants. Providers were uncertain whether New Mexico had the necessary infrastructure to support high-quality screening, and worried about access barriers and financial burdens for rural, underinsured populations. Providers noted the complexity of discussing benefits and harms of screening and surveillance with their patient population. Providers have several concerns about the feasibility and appropriateness of implementing LDCT screening. Effective lung cancer screening programs will need to educate providers and patients to support informed decision making and to ensure that high-quality screening can be efficiently delivered in community practice.

Smoking - adverse effects

Medically Underserved Area

Early Detection of Cancer - methods

Professional-Patient Relations

Early Detection of Cancer - psychology

Humans

Tomography, X-Ray Computed - methods

Male

Mass Screening - methods

Female

Interviews as Topic

Physician Assistants - psychology

Health Plan Implementation

Guideline Adherence - standards

Physicians, Primary Care - psychology

Risk Factors

Mass Screening - standards

Preventive Health Services - utilization

Radiation Dosage

Health Knowledge, Attitudes, Practice

Smoking Cessation - methods

Lung Neoplasms - prevention & control

New Mexico

Lung Neoplasms - diagnostic imaging

Qualitative Research

Directive Counseling - utilization

Details

Title: Subtitle: Attitudes and Beliefs of Primary Care Providers in New Mexico About Lung Cancer Screening Using Low-Dose Computed Tomography
Creators: Richard M Hoffman - University of New Mexico School of Medicine, University of New Mexico Cancer Center, Albuquerque Veterans Affairs Medical Center, Albuquerque, New Mexico
Andrew L Sussman - University of New Mexico Cancer Center and Department of Family Medicine and Community Medicine, Albuquerque, New Mexico
Christina M Getrich - Department of Anthropology, University of Maryland, College Park, Maryland
Robert L Rhyne - University of New Mexico Cancer Center and Department of Family Medicine and Community Medicine, Albuquerque, New Mexico
Richard E Crowell - University of New Mexico School of Medicine and University of New Mexico Cancer Center, Albuquerque, New Mexico
Kathryn L Taylor - Georgetown Lombardi Comprehensive Cancer Center and Georgetown University Medical Center, Washington, DC
Ellen J Reifler - Healthwise, Boise, Idaho
Pamela H Wescott - Healthwise, Boise, Idaho
Ambroshia M Murrietta - Clinical and Translational Science Center, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
Ali I Saeed - University of New Mexico School of Medicine and University of New Mexico Cancer Center, Albuquerque, New Mexico
Shiraz I Mishra - Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, NM 87131. Email: smishra@salud.unm.edu. Dr Mishra is also affiliated with the University of New Mexico Cancer Center and the Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico
Resource Type: Journal article
Publication Details: Preventing chronic disease, Vol.12(7), pp.E108-E108
DOI: 10.5888/pcd12.150112
PMID: 26160294
PMCID: PMC4509091
ISSN: 1545-1151
eISSN: 1545-1151
Grant note: R24 HD041041 / NICHD NIH HHS UL1 TR001449 / NCATS NIH HHS U48DP001931-05S1 / NCCDPHP CDC HHS U48 DP001931 / NCCDPHP CDC HHS
Language: English
Date published: 07/09/2015
Academic Unit: Epidemiology; General Internal Medicine; Internal Medicine
Record Identifier: 9984094510002771

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