Docs Aren’t Screening for Deadliest Cancer

One of the most important ways to beat cancer is to detect it early.

While clinical trials have shown that lung cancer screening using low-dose CT (LDCT) scans can detect cancers at a stage where they are more treatable, less than half the family physicians in a recent survey agreed that screening reduces lung cancer-related deaths.

Contrary to popular belief, you do not have to smoke to get this disease.

Lung cancer remains the leading cause of cancer deaths by far — in part because most cases are diagnosed at advanced stages. Contrary to popular belief, you do not have to smoke to get this disease. In addition, a majority of the diagnoses occurs in former smokers, many of whom don’t realize they are still at risk for the disease long after they stub out their last cigarette.

Published in CANCER, a peer-reviewed journal of the American Cancer Society, the findings indicate that there are gaps in physicians’ knowledge about appropriate lung cancer screening. Most were also unaware of current recommendations on lung cancer screening in high-risk patients.

The United States Preventive Services Task Force, Medicare, and multiple professional societies and organizations support the use of LDCT screening for high-risk patients, such as certain current and former smokers.

Some groups, including the American Academy of Family Physicians, assert there is not enough evidence to either recommend or discourage the use of LDCT screening, however.

To evaluate the knowledge, attitudes, and practice patterns related to lung cancer screening using LDCT among family physicians, Jan Eberth, Ph.D., of the University of South Carolina, along with her colleagues, distributed a 32-item questionnaire to South Carolina Academy of Family Physicians members in 2015.

Related: Real Answers on Cancer, Finally?

Of 101 respondents, most had incorrect knowledge about which organizations recommend screening. Although 98 percent felt LDCT screening increases the likelihood of detecting disease at earlier stages, only 41 percent believed screening reduced lung cancer-related deaths.

Also, while 75 percent felt that LDCT’s benefits outweigh potential harms, 88 percent had concerns about unnecessary procedures, 52 percent had concerns about stress/anxiety, and 50 percent had concerns about radiation exposure.

When asked whether they would recommend lung cancer screening with LDCT for a 60-year-old patient with a 30-year smoking history, 12 percent of physicians stated they would not recommend any screening, and 9 percent stated they would recommend a chest X-ray, even though LDCT is the only evidence-based screening strategy for a person with this background.

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“Education is needed to bridge these knowledge gaps and lay a foundation on which physicians can base their treatment recommendations,” said Dr. Eberth.

“With the Centers for Medicare and Medicaid Services now offering reimbursement to primary care providers to engage in shared decision-making with their patients about lung cancer screening, it is vital that providers have an accurate understanding of the eligibility criteria for screening and potential risks and benefits.”