Patient-provider discussions about lung cancer screening pre- and post-guidelines: Health Information National Trends Survey (HINTS)

Abstract

Objective: In 2013, the USPSTF issued a Grade B recommendation that long-term current and former smokers receive lung cancer screening. Shared decision-making is important for individuals considering screening, and patient-provider discussions an essential component of the process. We examined prevalence and predictors of lung cancer screening discussions pre- and post-USPSTF guidelines.

Methods: Data were obtained from two cycles of the Health Information National Trends Survey (2012; 2014). The analyzed sample comprised screening-eligible current and former smokers with no personal history of lung cancer (n=746 in 2012; n=795 in 2014). Descriptive and multiple logistic regression analyses were conducted; patient-reported discussion about lung cancer screening with provider was the outcome of interest.

Results: Contrary to expectations, patient-provider discussions about lung cancer screening were more prevalent pre-guideline, but overall patient-provider discussions were low in both years (17% in 2012; 10% in 2014). Current smokers were more likely to have had a discussion than former smokers. Significant predictors of patient-provider discussions included family history of cancer and having healthcare coverage.

Conclusions: The prevalence of patient-provider discussions about lung cancer screening is suboptimal.

Practice implications: There is a critical need for patient and provider education about shared decision-making and its importance in cancer screening decisions.

Keywords: HINTS; Health Information National Trends Survey; Health communication; Lung cancer screening; Patient-provider discussion; Shared decision making.

Figure 1. Flowchart of analyzed samples in 2012 and 2014