A qualitative study exploring why individuals opt out of lung cancer screening

Lung cancer screening with annual low-dose computed tomography is relatively new for long-term smokers in the USA supported by a US Preventive Services Task Force Grade B recommendation. As screening programs are more widely implemented nationally and providers engage patients about lung cancer scre...

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Bibliographic Details
Published in:Family practice 2017-04, Vol.34 (2), p.239-244
Main Authors: Carter-Harris, Lisa, Brandzel, Susan, Wernli, Karen J, Roth, Joshua A, Buist, Diana S M
Format: Article
Language:English
Subjects:
Aged
Early Detection of Cancer - methods
Female
Humans
Interviews as Topic
Lung Neoplasms - diagnosis
Male
Mass Screening - economics
Mass Screening - methods
Qualitative Research
Smoking - adverse effects
Social Stigma
Telephone - utilization
Tomography, X-Ray Computed
Washington
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Summary:Lung cancer screening with annual low-dose computed tomography is relatively new for long-term smokers in the USA supported by a US Preventive Services Task Force Grade B recommendation. As screening programs are more widely implemented nationally and providers engage patients about lung cancer screening, it is critical to understand behaviour among high-risk smokers who opt out to improve shared decision-making processes for lung cancer screening. The purpose of this study was to explore the reasons for screening-eligible patients' decisions to opt out of screening after receiving a provider recommendation. Semi-structured qualitative telephone interviews were performed with 18 participants who met lung cancer screening criteria for age, smoking and pack-year history in Washington State from November 2015 to January 2016. Two researchers with cancer screening and qualitative methodology expertise conducted data analysis using thematic content analytic procedures from audio-recorded interviews. Five primary themes emerged for reasons of opting out of lung cancer screening: (i) Knowledge Avoidance; (ii) Perceived Low Value; (iii) False-Positive Worry; (iv) Practical Barriers; and (v) Patient Misunderstanding. The participants in our study provided insight into why some patients make the decision to opt out of low-dose computed tomography screening, which provides knowledge that can inform intervention development to enhance shared decision-making processes between long-term smokers and their providers and decrease decisional conflict about screening.
ISSN:0263-2136
1460-2229
DOI:10.1093/fampra/cmw146