Patient-provider discussions about lung cancer screening pre- and post-guidelines: Health Information National Trends Survey (HINTS).
Lisa Carter-Harris, Andy S L Tan, Ramzi G Salloum and 1 others
PMID 27241830WHAT IT FOUND
Discussions about lung cancer screening were reported by 17% of current and former smokers aged 55 to 80 in 2012 and 10% in 2014.
Current smokers and insured patients were more likely to report a discussion.
Key findings
01In 2012, 17% of respondents reported a discussion about lung cancer screening; in 2014, 10% reported one.
02Respondents in 2014 had 53% lower odds of reporting a discussion than respondents in 2012.
03Current smokers, those with a family history of cancer, and those with healthcare coverage had higher odds of reporting a discussion.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The survey asked one question about a past-year discussion. It is a proxy for shared decision-making, not a measure of the quality of the conversation. The question did not say whether the patient or the provider started the conversation. The survey did not collect pack-year smoking history, so the sample was not fully screened for USPSTF eligibility. Because this was a cross-sectional survey, it cannot show that the guidelines caused the lower discussion rate. Missing predictor values accounted for 16% of the analyzed sample, and the authors kept them as a separate category. The low overall discussion rate may create a floor effect. Differences by race or ethnicity may be hard to detect.
Declared interests
The authors declared no conflicts of interest. The article is listed as NIH extramural research support.
The easy way to misread this
Do not read the lower 2014 percentage as proof that the guidelines caused fewer discussions. This is a cross-sectional survey using a single self-report item, so it cannot show why the change occurred.