ArticleAmerican journal of preventive medicine2021
Variation in Eligible Patients' Agreeing to and Receiving Lung Cancer Screening: A Cohort Study.
Article in American journal of preventive medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 14 citations in OpenAlex.
- "I Was Expecting the Worst": Exploring Barriers and Facilitators to Lung Cancer Screening in Black and Hispanic Communities.Journal of general internal medicine · 2026Article
- Transportation-related factors, cancer screening, and stage at diagnosis: A scoping review.PloS one · 2026Article
- Are comorbidities associated with differences in healthcare charges among lung cancer patients in US hospitals? Focusing on variances by patient and socioeconomic factors.Chronic illness · 2024Article
- Review
- Prediction-Augmented Shared Decision-Making and Lung Cancer Screening Uptake.JAMA network open · 2024Article
- The role of lung cancer risk and comorbidity in lung cancer screening use.Preventive medicine reports · 2022Article
- Lost to follow up?: A qualitative study of why some patients do not pursue lung cancer screening.Preventive medicine reports · 2022Article
- Factors Associated With Declining Lung Cancer Screening After Discussion With a Physician in a Cohort of US Veterans.JAMA network open · 2022Article
- Implementation of a Web-Based Tool for Shared Decision-making in Lung Cancer Screening: Mixed Methods Quality Improvement Evaluation.JMIR human factors · 2022Article
- Implementing lung cancer screening in primary care: needs assessment and implementation strategy design.Translational behavioral medicine · 2022Article
- Factors Associated with Decision Aid Use in Localized Prostate Cancer.Urology practice · 2022Article
- Motivation is not enough: A qualitative study of lung cancer screening uptake in Australia to inform future implementation.PloS one · 2022Article
- Comorbidity Profiles and Lung Cancer Screening among Older Adults: U.S. Behavioral Risk Factor Surveillance System 2017-2019.Annals of the American Thoracic Society · 2021Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
introductionLittle is known about how clinicians make low-dose computed tomography lung cancer screening decisions in practice. Investigators assessed the factors associated with real-world decision making, hypothesizing that lung cancer risk and comorbidity would not be associated with agreeing to or receiving screening. Though these factors are key determinants of the benefit of lung cancer screening, they are often difficult to incorporate into decisions without the aid of decision tools.
methodsThis was a retrospective cohort study of patients meeting current national eligibility criteria and deemed appropriate candidates for lung cancer screening on the basis of clinical reminders completed over a 2-year period (2013-2015) at 8 Department of Veterans Affairs medical facilities. Multilevel mixed-effects logistic regression models (conducted in 2019-2020) assessed predictors (age, sex, lung cancer risk, Charlson Comorbidity Index, travel distance to facility, and central versus outlying decision-making location) of primary outcomes of agreeing to and receiving lung cancer screening.
resultsOf 5,551 patients (mean age=67 years, 97% male, mean lung cancer risk=0.7%, mean Charlson Comorbidity Index=1.14, median travel distance=24.2 miles), 3,720 (67%) agreed to lung cancer screening and 2,398 (43%) received screening. Lung cancer risk and comorbidity score were not strong predictors of agreeing to or receiving screening. Empirical Bayes adjusted rates of agreeing to and receiving screening ranged from 22% to 84% across facilities and from 19% to 85% across clinicians. A total of 33.7% of the variance in agreeing to and 34.2% of the variance in receiving screening was associated with the facility or the clinician offering screening.
conclusionsSubstantial variation was found in Veterans agreeing to and receiving lung cancer screening during the Veterans Affairs Lung Cancer Screening Demonstration Project. This variation was not explained by differences in key determinants of patient benefit, whereas the facility and clinician advising the patient had a large impact on lung cancer screening decisions.
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