The complicated ‘Yes’: Decision-making processes and receptivity to lung cancer screening among head and neck cancer survivors

Aaron T Seaman; Kimberly Dukes; Richard M Hoffman; Alan J Christensen; Nicholas Kendell; Andrew L Sussman; Miriam Veléz-Bermúdez; Robert J Volk; Nitin A Pagedar

doi:10.1016/j.pec.2018.04.012

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The complicated ‘Yes’: Decision-making processes and receptivity to lung cancer screening among head and neck cancer survivors

Journal article

Peer reviewed

The complicated ‘Yes’: Decision-making processes and receptivity to lung cancer screening among head and neck cancer survivors

Aaron T Seaman, Kimberly Dukes, Richard M Hoffman, Alan J Christensen, Nicholas Kendell, Andrew L Sussman, Miriam Veléz-Bermúdez, Robert J Volk and Nitin A Pagedar

Patient education and counseling, Vol.101(10), pp.1741-1747

10/2018

DOI: 10.1016/j.pec.2018.04.012

PMCID: PMC6119119

PMID: 29709410

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https://www.ncbi.nlm.nih.gov/pmc/articles/6119119View

Open Access

Abstract

•Qualitatively examines head and neck cancer survivors’ perspectives on lung cancer screening.•Survivors were receptive to lung cancer screening, minimizing potential harms.•They drew upon their head and neck cancer experiences as they considered screening.•Lung cancer screening discussions are complicated by head and neck cancer survivors’ history.•Specialty care settings might be more appropriate for screening discussions with this population. Shared decision making (SDM) is recommended when offering lung cancer screening (LCS)—which presents challenges with tobacco-related cancer survivors because they were excluded from clinical trials. Our objective was to characterize head and neck cancer (HNC) survivors’ knowledge, attitudes, and beliefs toward LCS and SDM. Between November 2017 and June 2018, we conducted semi-structured qualitative interviews with 19 HNC survivors, focusing on patients’ cancer and smoking history, receptivity to and perceptions of LCS, and decision-making preferences Participants were receptive to LCS, referencing their successful HNC outcomes. They perceived that LCS might reduce uncertainty and emphasized the potential benefits of early diagnosis. Some expressed concern over costs or overdiagnosis, but most minimized potential harms, including false positives and radiation exposure. Participants preferred in-person LCS discussions, often ideally with their cancer specialist. HNC survivors may have overly optimistic expectations for LCS, and clinicians need to account for this in SDM discussions. Supporting these patients in making informed decisions will be challenging because we lack clinical data on the potential benefits and harms of LCS for cancer survivors. While some patients prefer discussing LCS with their cancer specialists, the ability of specialists to support high-quality decision making is uncertain.

Practices

Qualitative research

Health knowledge

Head and neck neoplasms

Decision making

Attitudes

Early detection of cancer

Shared

Lung neoplasms

Details

Title: Subtitle: The complicated ‘Yes’: Decision-making processes and receptivity to lung cancer screening among head and neck cancer survivors
Creators: Aaron T Seaman - Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, USA
Kimberly Dukes - Institute for Clinical and Translational Science, University of Iowa Hospitals and Clinics, Iowa City, USA
Richard M Hoffman - Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, USA
Alan J Christensen - Department of Psychological and Brain Sciences, University of Iowa, Iowa City, USA
Nicholas Kendell - Department of Otolaryngology—Head and Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, USA
Andrew L Sussman - Family and Community Medicine, University of New Mexico, Albuquerque, USA
Miriam Veléz-Bermúdez - Department of Psychological and Brain Sciences, University of Iowa, Iowa City, USA
Robert J Volk - Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, USA
Nitin A Pagedar - Department of Otolaryngology—Head and Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, USA
Resource Type: Journal article
Publication Details: Patient education and counseling, Vol.101(10), pp.1741-1747
DOI: 10.1016/j.pec.2018.04.012
PMID: 29709410
PMCID: PMC6119119
NLM abbreviation: Patient Educ Couns
ISSN: 0738-3991
eISSN: 1873-5134
Publisher: Elsevier B.V
Grant note: name: National Cancer Institute of the National Institutes of Health under the Award Number, award: UG1CA189823, U10CA180858; name: Center for Advancing Translational Sciences of the National Institutes of Health, award: U54TR001356
Language: English
Date published: 10/2018
Academic Unit: Epidemiology; Psychological and Brain Sciences; Center for Social Science Innovation; General Internal Medicine; Community and Behavioral Health; Otolaryngology; Internal Medicine
Record Identifier: 9984063142302771

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