Effects of Personalized Risk Information on Patients Referred for Lung Cancer Screening with Low-Dose CT

Paul K. J. Han, Christine Lary, Adam Black, Caitlin Gutheil, Hayley Mandeville, Jason Yahwak and Mayuko Fukunaga
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Paul K. J. Han: Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME, USA
Christine Lary: Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME, USA
Adam Black: Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME, USA
Caitlin Gutheil: Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME, USA
Hayley Mandeville: Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME, USA
Jason Yahwak: Chest Medicine Associates, Portland, ME, USA
Mayuko Fukunaga: Department of Population Health Sciences, University of Massachusetts, Worcester, MA, USA

Medical Decision Making, 2019, vol. 39, issue 8, 950-961

Abstract: Background. Low-dose computed tomography (LDCT) screening for lung cancer is a preference-sensitive intervention that should ideally be individualized according to patients’ likelihood of benefit and personal values. Personalized cancer risk information (PCRI) may facilitate this goal, but its effects are unknown. Objective. To evaluate the effects of providing PCRI to patients referred for LDCT screening. Design. Mixed-methods, pre-post study using surveys administered to patients before and after provision of PCRI—calculated by the PLCOm2012 risk prediction model—in shared decision-making consultations, and postvisit qualitative interviews. Setting. Centralized specialty-based LDCT screening program at a tertiary care hospital. Participants. Convenience sample of eligible patients referred for LDCT screening. Measurements. Pre- and postvisit surveys assessed patients’ 1) perceived lung cancer risk, 2) uncertainty about their risk, 3) minimum risk threshold for wanting screening, 4) interest in LDCT screening, and 5) interest in smoking cessation. Qualitative interviews explored patients’ perceptions of the value of PCRI. Screening uptake was assessed by chart review. Results. Sixty of 70 (86%) patients received PCRI and completed pre-post surveys, and 17 patients (28%) completed qualitative interviews. Perceived lung cancer risk decreased from 52% previsit to 31% postvisit ( P

Keywords: lung cancer; risk perceptions; risk prediction; screening (search for similar items in EconPapers)
Date: 2019
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Citations: View citations in EconPapers (3)

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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:39:y:2019:i:8:p:950-961

DOI: 10.1177/0272989X19875966

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