A qualitative study exploring why individuals opt out of lung cancer screening

TY - JOUR

T1 - A qualitative study exploring why individuals opt out of lung cancer screening

AU - Carter-Harris, Lisa

AU - Brandzel, Susan

AU - Wernli, Karen J.

AU - Roth, Joshua A.

AU - Buist, Diana S.M.

N1 - Publisher Copyright: © The Author 2017. Published by Oxford University Press. All rights reserved.

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Background. Lung cancer screening with annual low-dose computed tomography is relatively new for long-term smokers in the USA supported by a US Preventive Services Task Force Grade B recommendation. As screening programs are more widely implemented nationally and providers engage patients about lung cancer screening, it is critical to understand behaviour among highrisk smokers who opt out to improve shared decision-making processes for lung cancer screening. Objective. The purpose of this study was to explore the reasons for screening-eligible patients' decisions to opt out of screening after receiving a provider recommendation. Methods. Semi-structured qualitative telephone interviews were performed with 18 participants who met lung cancer screening criteria for age, smoking and pack-year history in Washington State from November 2015 to January 2016. Two researchers with cancer screening and qualitative methodology expertise conducted data analysis using thematic content analytic procedures from audio-recorded interviews. Results. Five primary themes emerged for reasons of opting out of lung cancer screening: (i) Knowledge Avoidance; (ii) Perceived Low Value; (iii) False-Positive Worry; (iv) Practical Barriers; and (v) Patient Misunderstanding. Conclusion. The participants in our study provided insight into why some patients make the decision to opt out of low-dose computed tomography screening, which provides knowledge that can inform intervention development to enhance shared decision-making processes between long-term smokers and their providers and decrease decisional conflict about screening.

AB - Background. Lung cancer screening with annual low-dose computed tomography is relatively new for long-term smokers in the USA supported by a US Preventive Services Task Force Grade B recommendation. As screening programs are more widely implemented nationally and providers engage patients about lung cancer screening, it is critical to understand behaviour among highrisk smokers who opt out to improve shared decision-making processes for lung cancer screening. Objective. The purpose of this study was to explore the reasons for screening-eligible patients' decisions to opt out of screening after receiving a provider recommendation. Methods. Semi-structured qualitative telephone interviews were performed with 18 participants who met lung cancer screening criteria for age, smoking and pack-year history in Washington State from November 2015 to January 2016. Two researchers with cancer screening and qualitative methodology expertise conducted data analysis using thematic content analytic procedures from audio-recorded interviews. Results. Five primary themes emerged for reasons of opting out of lung cancer screening: (i) Knowledge Avoidance; (ii) Perceived Low Value; (iii) False-Positive Worry; (iv) Practical Barriers; and (v) Patient Misunderstanding. Conclusion. The participants in our study provided insight into why some patients make the decision to opt out of low-dose computed tomography screening, which provides knowledge that can inform intervention development to enhance shared decision-making processes between long-term smokers and their providers and decrease decisional conflict about screening.

KW - Cancer screening

KW - Decision making and qualitative research

KW - Lung cancer

KW - Patients

KW - Primary health care

UR - http://www.scopus.com/inward/record.url?scp=85018992940&partnerID=8YFLogxK

U2 - 10.1093/fampra/cmw146

DO - 10.1093/fampra/cmw146

M3 - Article

C2 - 28122849

SN - 0263-2136

VL - 34

SP - 239

EP - 244

JO - Family practice

JF - Family practice

IS - 2

ER -