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BACKGROUND: Lung cancer is the second most common cancer diagnosis and the leading cause of cancer death among men and women in Kansas. Prior to the December 2013 US Preventive Services Task Force (USPSTF) guidelines recommending annual lung cancer screening with low-dose computed tomography (LDCT) among high-risk individuals, the American Cancer Society (ACS) released interim guidance that recommended physicians discuss lung cancer screening using LDCT with patients at high risk for developing the disease and together decide whether or not to undergo screening.
METHODS: We explored patient-provider discussions about lung cancer screening among high risk individuals in the 2012-2013 Kansas Adult Tobacco Survey (ATS), a point-in-time random-digit-dial-survey of non-institutionalized Kansas adults. High-risk individuals were defined as current smokers and former smokers who had their last cigarette in the past 15 years, aged 55 to 74 years, with no history of cancer. Weighted overall and sub-population prevalence estimates, as well as crude and adjusted odds ratios, were calculated using SAS survey procedures to examine characteristics associated with discussing screening among high-risk individuals. Potential confounders were assessed during logistic regression model building.
RESULTS: Of the 9,656 Kansas adults who completed the survey, 733 were identified as high risk. The prevalence of patient-provider discussions about lung cancer screening among high-risk individuals was 31.0% (95% CI 27.0-35.0). The adjusted prevalence odds of having these discussions was higher among males (1.58; 95% CI 1.08-2.31), adults aged 65 to 74 years (1.70; 95% CI 1.16-2.50), and adults living with a disability (1.61; 95% CI 1.09-2.38). The adjusted prevalence odds were also higher among those who saw a health professional in the past year and had their smoking status assessed (1.78; 95% CI 1.02-3.09) or were advised to quit (2.50; 95% CI 1.54-4.07). Adjusted models controlled for age, gender and disability status.
CONCLUSIONS: In 2012/2013, nearly one-third of high risk Kansas adults had ever discussed lung cancer screening with their health care provider. The prevalence odds of these discussions varied by age, gender, disability status, and receipt of smoking status assessment or advice to quit from a health provider. Results may inform strategies to increase patient-provider discussions of lung cancer screening among high risk individuals.