Lung cancer screening practices among primary care providers in Northern Texas

Background : The U.S. Preventive Services Task Forces (USPSTF) has recommended lung cancer screening with low-dose computed tomography (LDCT) in high- risk patients; however, the number of eligible patients receiving LDCT screening is still low. To understand current implementation and barriers to LDCT screening among primary care providers, a survey was conducted among members of the North Texas Primary Care Practice-Based Research Network (NorTex) between July and November 2018. The survey included questions regarding knowledge of lung cancer screening guidelines, perceptions, practice and barriers to LDCT screening. A total of 36 primary care providers completed the survey (response rate = 18%). Results: Overall, 69.4% of respondents indicated that lung cancer screening with LDCT was recommended by USPSTF. 91.7% of providers believed that the LDCT is effective in reducing lung cancer mortality for high-risk patients, while only 33.3% had referred most of high risk patients for LDCT screening in the past 12 months. Common perceived barriers to LDCT included concerns regarding insurance coverage, the cost of the test, and uncertainty of the benefits of the test. Conclusions: Approximately 70% of primary care providers are familiar with the USPSTF guidelines for lung cancer screening and a number of providers’ barriers to adherence to guideline are persistent. Further study of provider-based intervention is needed to improve screening implementation.