ABSTRACT: Physicians’ Knowledge and Practice of Lung Cancer Screening: A Cross-Sectional Survey Comparing General Practitioners, Thoracic Oncologists, and Pulmonologists in France.
Screening for lung cancer by low-dose computed tomography scan (LDCTS) has been demonstrated to reduce lung cancer-specific and overall mortality rates in high-risk individuals. From trial to clinical practice, it is crucial to obtain an accurate level of knowledge of the physicians who will recruit patients for a screening program. The actual current practice and knowledge of practitioners are unknown. This could be critical to develop dedicated continuous medical education programs.
MATERIALS AND METHODS:
Three groups of French physicians-pulmonologists (PUs), thoracic oncologists (TOs), and general practitioners (GPs)-were surveyed through a dedicated questionnaire on lung cancer screening.
A total of 242 physicians answered the questionnaire; 81% of TOs knew that LDCTS showed efficacy for screening lung cancer compared with 52% of PUs and 18% of GPs (P < .0001). Approximately one third of physicians recommended lung cancer screening in daily practice at the time of the survey, including 53% of PUs, 34% of TOs, and 20% of GPs (P < .001). However, 94% of GPs, 44% of PUs, and 33% of TOs used inappropriate tests, mainly chest radiography. Most GPs proposed screening for all smokers, whereas PUs and TOs reserved screening for heavy smokers (P = .040). Most PUs and TOs recommended annual LDCTS (76%), whereas the majority of GPs sent patients for screening tests every 3 to 5 years (93%; P < .0001).
These results highlight the interest of physicians for lung cancer screening; meanwhile, our data stress the need for appropriate medical education and recommendations based on available evidence.