Understanding the decision to screen for lung cancer or not: A qualitative analysis

TY - JOUR

T1 - Understanding the decision to screen for lung cancer or not

T2 - A qualitative analysis

AU - Draucker, Claire Burke

AU - Rawl, Susan M.

AU - Vode, Emilee

AU - Carter-Harris, Lisa

N1 - Publisher Copyright: © 2019 The Authors Health Expectations published by John Wiley & Sons Ltd

PY - 2019/12/1

Y1 - 2019/12/1

N2 - Background: Although new screening programmes with low-dose computed tomography (LDCT) for lung cancer have been implemented throughout the United States, screening uptake remains low and screening-eligible persons' decisions to screen or not remain poorly understood. Objective: To describe how current and former long-term smokers explain their decisions regarding participation in lung cancer screening. Design: Phone interviews using a semi-structured interview guide were conducted to ask screening-eligible persons to describe their decisions regarding screening with LDCT. The interviews were transcribed and analysed with conventional content analytic techniques. Setting and participants: A subsample of 40 participants (20 who had screened and 20 who had not) were drawn from the sample of a survey study whose participants were recruited by Facebook targeted advertisements. Results: The sample was divided into the following five groups based on their decisions regarding lung cancer screening participation: Group 1: no intention to be screened, Group 2: no deliberate consideration but somewhat open to being screened, Group 3: deliberate consideration but no definitive decision to be screened, Group 4: intention to be screened and Group 5: had been screened. Reasons for screening participation decisions are described for each group. Across groups, data revealed that screening-eligible persons have a number of misconceptions regarding LDCT, including that a scan is needed only if one is symptomatic or has not had a chest x-ray. A physician recommendation was a key influence on decisions to screen. Discussion and conclusions: Education initiatives aimed at providers and long-term smokers regarding LDCT is needed. Quality patient/provider communication is most likely to improve screening rates.

AB - Background: Although new screening programmes with low-dose computed tomography (LDCT) for lung cancer have been implemented throughout the United States, screening uptake remains low and screening-eligible persons' decisions to screen or not remain poorly understood. Objective: To describe how current and former long-term smokers explain their decisions regarding participation in lung cancer screening. Design: Phone interviews using a semi-structured interview guide were conducted to ask screening-eligible persons to describe their decisions regarding screening with LDCT. The interviews were transcribed and analysed with conventional content analytic techniques. Setting and participants: A subsample of 40 participants (20 who had screened and 20 who had not) were drawn from the sample of a survey study whose participants were recruited by Facebook targeted advertisements. Results: The sample was divided into the following five groups based on their decisions regarding lung cancer screening participation: Group 1: no intention to be screened, Group 2: no deliberate consideration but somewhat open to being screened, Group 3: deliberate consideration but no definitive decision to be screened, Group 4: intention to be screened and Group 5: had been screened. Reasons for screening participation decisions are described for each group. Across groups, data revealed that screening-eligible persons have a number of misconceptions regarding LDCT, including that a scan is needed only if one is symptomatic or has not had a chest x-ray. A physician recommendation was a key influence on decisions to screen. Discussion and conclusions: Education initiatives aimed at providers and long-term smokers regarding LDCT is needed. Quality patient/provider communication is most likely to improve screening rates.

KW - behaviour

KW - long-term smokers

KW - lung cancer screening

KW - qualitative

UR - http://www.scopus.com/inward/record.url?scp=85073919196&partnerID=8YFLogxK

U2 - 10.1111/hex.12975

DO - 10.1111/hex.12975

M3 - Article

C2 - 31560837

SN - 1369-6513

VL - 22

SP - 1314

EP - 1321

JO - Health Expectations

JF - Health Expectations

IS - 6

ER -