High-risk patients show low interest in lung cancer screening

  • Byrne MM & al.
  • Cancer Med
  • 6 Aug 2019

  • curated by Craig Hicks
  • Univadis Clinical Summaries
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Takeaway

  • High-risk patients show low interest in lung cancer screening (LCS) and are more concerned about out-of-pocket costs than about potential benefits or risks.

Why this matters

  • Patients need more education and support for informed decision-making when considering LCS.

Study design

  • Researchers used conjoint analysis, a survey-based statistical technique used in market research, to examine patient propensity and preferences for LCS.
  • Survey participants were patients eligible for LCS with no history of lung cancer and ≥20 pack-year history (N=210; mean age, 61±8.5 years; 51.9% women).
  • Funding: National Cancer Institute.

Key results

  • Average LCS screening propensity on a 1-9 scale was 3.63±1.6.
  • Average relative importance of LCS program attributes, from high to low:
    • Out-of-pocket costs (27.3±17.7).
    • Provider recommendation (24.8±13.4).
    • Mortality reduction (17.2±8.9).
    • False-positive rate (15.8±10.4).
    • Ease of access (14.8±7.3).
  • Across 22 hypothetical scenarios, average LCS screening propensity ranged from 2.60±2.00 to 5.57±2.13.
    • Best scenario involved $100 out-of-pocket costs, 10% mortality reduction, primary care recommendation to screen, 10% false‐positive rate, and inconvenient location, but open evenings and weekends. 
    • Even with these attributes, mean willingness to screen was just over the midpoint from "definitely no" to "definitely yes."

    Limitations

    • Screening propensity and attribute preferences in a hypothetical scenario are treated as real-world propensity and preferences.

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