Abstract
Racial/ethnic minorities face stark inequalities in lung cancer incidence, treatment, survival, and mortality compared with US born non-Hispanic Whites. Lung cancer screening (LCS) with low-dose computed tomography (LDCT) is effective at reducing lung cancer mortality in high-risk current and former smokers and is recommended by the US Preventive Services Task Force (USPSTF). This study sought to assess primary care providers’ (PCPs’) knowledge, attitudes, beliefs, and practice related to LCS and the recent USPSTF guidelines in five high-risk immigrant communities in New York City. We surveyed 83 eligible PCPs between December 2016 and January 2018 through surveys sent by mail, email, and fax, administered by phone or in person. The survey included questions about providers’ clinical practice, knowledge, attitudes, and beliefs related to LCS and the USPSTF guidelines. Information about patient demographics, PCPs’ training background, and practice type were also collected. Sixty-seven percent of respondents reported that they did not have established guidelines for LCS at their practice, and 52% expressed that “vague” screening criteria influenced their referral processes for LCS. Barriers to LCS with LDCT included concerns that LDCT is not covered by insurance, patients’ fears of screening results, and patients’ concerns regarding radiation exposure. Targeted educational interventions for both PCPs and patients may increase access to recommended LCS, especially for populations at disproportionate risk for lung cancer.
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Funding
This study was funded by the following grants: CCNY-MSKCC Partnership for Cancer Research, Training, and Community Outreach (5 U54 CA137788-08) and a Cancer Center Support Grant: Population Science Research Program (P30 CA008748).
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Jennifer Leng was the lead in project conception, development, implementation, and manuscript writing and provided overall guidance and direction; Shu Fang Lei, Lei Lei, and Jeralyn Cortez contributed to data collection; John Capua conducted the data analysis; Florence Lui contributed to manuscript development; and Francesca Gany provided overall supervision, oversight, and guidance.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. The study was reviewed and approved by MSKCC’s Institutional Review Board.
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Leng, J., Lei, S.F., Lei, L. et al. Primary Care Providers’ Knowledge, Attitudes, Beliefs, and Practice Related to Lung Cancer Screening in Five High-Risk Communities in New York City. J Canc Educ 37, 631–640 (2022). https://doi.org/10.1007/s13187-020-01857-4
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DOI: https://doi.org/10.1007/s13187-020-01857-4