Current lung cancer screening practice amongst general practitioners in Western Australia: a cross-sectional study

2018 ◽  
Vol 48 (1) ◽  
pp. 78-80 ◽  
Author(s):  
David Manners ◽  
Helen Wilcox ◽  
Annette McWilliams ◽  
Francesco Piccolo ◽  
Helena Liira ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
General Practitioners ◽  
Western Australia ◽  
Lung Cancer Screening ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Screening Practice

When Is a Harm a Harm? Discordance between Patient and Medical Experts’ Evaluation of Lung Cancer Screening Attributes

2021 ◽  
Vol 41 (3) ◽  
pp. 317-328
Author(s):  
Marilyn M. Schapira ◽  
Keri L. Rodriguez ◽  
Sumedha Chhatre ◽  
Liana Fraenkel ◽  
Lori A. Bastian ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Radiation Exposure ◽  
Incidental Findings ◽  
Medical Center ◽  
Indirect Costs ◽  
Lung Cancer Screening ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Semistructured Interviews

Background A shared decision-making (SDM) process for lung cancer screening (LCS) includes a discussion between clinicians and patients about benefits and potential harms. Expert-driven taxonomies consider mortality reduction a benefit and consider false-positives, incidental findings, overdiagnosis, overtreatment, radiation exposure, and direct and indirect costs of LCS as potential harms. Objective To explore whether patients conceptualize the attributes of LCS differently from expert-driven taxonomies. Design Cross-sectional study with semistructured interviews and a card-sort activity. Participants Twenty-three Veterans receiving primary care at a Veterans Affairs Medical Center, 55 to 73 y of age with 30 or more pack-years of smoking. Sixty-one percent were non-Hispanic African American or Black, 35% were non-Hispanic White, 4% were Hispanic, and 9% were female. Approach Semistructured interviews with thematic coding. Main Measures The proportion of participants categorizing each attribute as a benefit or harm and emergent themes that informed this categorization. Key Results In addition to categorizing reduced lung cancer deaths as a benefit (22/23), most also categorized the following as benefits: routine annual screening (8/9), significant incidental findings (20/23), follow-up in a nodule clinic (20/23), and invasive procedures (16/23). Four attributes were classified by most participants as a harm: false-positive (13/22), overdiagnosis (13/23), overtreatment (6/9), and radiation exposure (20/22). Themes regarding the evaluation of LCS outcomes were 1) the value of knowledge about body and health, 2) anticipated positive and negative emotions, 3) lack of clarity in terminology, 4) underlying beliefs about cancer, and 5) risk assessment and tolerance for uncertainty. Conclusions Anticipating discordance between patient- and expert-driven taxonomies of the benefits and harms of LCS can inform the development and interpretation of value elicitation and SDM discussions.

scholarly journals How do general practitioners put preventive care recommendations into practice? A cross-sectional study in Switzerland and France

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e017958 ◽  
Author(s):  
Paul Sebo ◽  
Bernard Cerutti ◽  
Jean-Pascal Fournier ◽  
Cédric Rat ◽  
Fabien Rougerie ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
General Practitioners ◽  
Prostate Cancer Screening ◽  
Cross Sectional Study ◽  
Hazardous Drinking ◽  
Shared Decision ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hazardous Alcohol

ObjectivesWe previously identified that general practitioners (GPs) in French-speaking regions of Europe had a variable uptake of common preventive recommendations. In this study, we describe GPs’ reports of how they put different preventive recommendations into practice.Design, setting and participantsCross-sectional study conducted in 2015 in Switzerland and France. 3400 randomly selected GPs were asked to complete a postal (n=1100) or online (n=2300) questionnaire. GPs who exclusively practiced complementary and alternative medicine were not eligible for the study. 764 GPs (response rate: postal 47%, online 11%) returned the questionnaire (428 in Switzerland and 336 in France).Main outcome measuresWe investigated how the GPs performed five preventive practices (screening for dyslipidaemia, colorectal and prostate cancer, identification of hazardous alcohol consumption and brief intervention), examining which age group they selected, the screening frequency, the test they used, whether they favoured shared decision for prostate cancer screening and their definition of hazardous alcohol use.ResultsA large variability was observed in the way in which GPs provide these practices. 41% reported screening yearly for cholesterol, starting and stopping at variable ages. 82% did not use any test to identify hazardous drinking. The most common responses for defining hazardous drinking were, for men, ≥21 drinks/week (24%) and ≥4 drinks/occasion for binge drinking (20%), and for women, ≥14 drinks/week (28%) and ≥3 drinks/occasion (21%). Screening for colorectal cancer, mainly with colonoscopy in Switzerland (86%) and stool-based tests in France (93%), was provided every 10 years in Switzerland (65%) and 2 years in France (91%) to patients between 50 years (87%) and 75 years (67%). Prostate cancer screening, usually with shared decision (82%), was provided yearly (62%) to patients between 50 years (74%) and 75–80 years (32%–34%).ConclusionsThe large diversity in the way these practices are provided needs to be addressed, as it could be related to some misunderstandingof the current guidelines, to barriers for guideline uptake or, more likely, to the absence of agreement between the various recommendations.

scholarly journals Determining the perception of a lung cancer screening programme among high-risk patients in a tertiary referral centre, Kuala Lumpur

2019 ◽  
Vol 29 (1) ◽  
pp. 19-24
Author(s):  
Wei Hao Kok ◽  
Andrea Ban Yu-Lin ◽  
Shamsul Azhar Shah ◽  
Faisal Abdul Hamid
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
High Risk ◽  
Screening Programme ◽  
Lung Cancer Screening ◽  
High Risk Population ◽  
Willingness To Participate ◽  
Tertiary Referral Centre ◽  
Cross Sectional ◽  
Cancer Screening Programme

Background: Lung cancer is the second most common cause of cancer-related death and the third most common cancer in Malaysia. The rising prevalence of lung cancer suggests the need to consider disease screening for early detection, especially in the high-risk population, as it offers the best chance of cure. Objectives: The study aims to determine the willingness of high-risk respondents to participate in a lung cancer screening programme if made available to them, and to determine their attitude towards lung cancer screening and explore factors that might affect participation in a screening programme. Method: This is a cross-sectional, descriptive study over 6 months conducted in adult patients attending medical clinics in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) using face-to-face administered questionnaires. Results: In total 180 respondents were analysed. There were 177 (98.3%) males. Mean age was 59.8 ± 9.1 years. Of the respondents, 138 (76.7%) had poor knowledge about cancer screening. Former smokers comprised 119 (66.1%) of the participants, and 61 (33.9%) were current smokers. In total, 141 (78.3%) respondents indicated willingness to participate in a lung cancer screening programme. Out of this group, 68 (48.2%) respondents were unwilling to pay for the procedure. Only 18 (12.8%) were unwilling to undergo lung cancer treatment if detected early. Conclusions: Awareness about general cancer screening is low. Our study showed that when informed of their high-risk status, respondents were willing to participate in lung cancer screening. There should be more health programmes to promote and raise awareness about lung cancer.

scholarly journals Healthcare utilisation, cancer screening and potential barriers to accessing cancer care in rural South West Nigeria: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e040352
Author(s):  
Avinash Sharma ◽  
Olusegun Isaac Alatise ◽  
Kelli O'Connell ◽  
Samson Gbenga Ogunleye ◽  
Adewale Abdulwasiu Aderounmu ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Cancer Care ◽  
Healthcare Utilisation ◽  
Cross Sectional Study ◽  
Personal Income ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Potential Barriers ◽  
South West

Background/aimsCancer burden is predicted to double by 2030 in sub-Saharan Africa; access to healthcare services for cancer management is a priority in the region. In Nigeria, National Cancer Control Plan aims to ensure >50% cancer screening of eligible populations by 2022 for all Nigerians. We describe healthcare utilisation, cancer screening activities and potential barriers to accessing cancer care within an understudied rural community-based adult population in South West Nigeria.MethodsIn April 2018, we conducted a cross-sectional study of community-based adults (>18 years) ~130 km east of Ibadan, 250 km from Lagos in Osun State, South West Nigeria. Participants completed a face-to-face survey in local dialect. We used a questionnaire to assess demographics, health status, income, medical expenditures, doctor visits and cancer screening history.ResultsWe enrolled 346 individuals: with median age of 52 years and 75% women. Of the entire cohort, 4% had medical insurance. 46% reported a major medical cost in the last year. Cancer screening activities were infrequent in eligible participants: 1.5% reported having had cervical cancer screening, 3.3% mammogram and 5% colonoscopy screening. Cancer screening assessment was less frequent in those with less income and lower education levels. Using a multivariable logistic regression model including personal income, insurance status and education, higher personal income was associated with more cancer screening activity (OR 2.7, 95% CI 1.3 to 5.7, p<0.01). Despite this, most individuals had contact with a primary healthcare doctor (52% in the last year), and over 70% access to radio and TV suggesting the opportunity to expand community-based screening interventions and awareness exists.ConclusionsDespite national increases in cancer cases, we highlight a deficiency in cancer screening and universal healthcare coverage within a community-based adult Nigerian population. Subject to availability of governmental resources, increasing financial risk protection, awareness and targeted resource allocation may help expand access in Nigeria.

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