RESIDENTS’ AND FELLOWS’ COLUMN C. MATTHEW HAWKINS, MD

US Preventive Services Task Force CT Lung Cancer Screening Recommendations: Community Awareness and Perceptions Michele Retrouvey, MD, Zeal Patel, MD, Sarah Shaves, MD A BRIEF DESCRIPTION OF THE PROBLEM OR CHALLENGE Although lung cancer is the third most common type of cancer diagnosed, it remains the leading cause of death from cancer in the United States for both men and women [1]. The average 5-year survival rate is low, hovering under 20%. However, the survival rate is considerably higher (approximately 50%) when lung cancer is diagnosed early, while the tumor remains localized. Yet currently, the large majority of lung cancer patients are diagnosed with more extensive disease [2]. Given the well-known risk factors for lung cancer and its better prognosis when caught early, targeting high-risk individuals for screening is important. Research has shown a significant decrease in morbidity and mortality secondary to CT lung cancer screening [3]. Hence, the US Preventive Services Task Force favors recommending low-dose CT lung cancer screening of high-risk adults [4]. The ACR supports this recommendation for screening of adults aged 55 to 80 years who have a 30 pack-year smoking history and either currently smoke or have quit smoking within the past 15 years. The prevalence of individuals that would benefit from this new screening test in urban, low-socioeconomic environments was thought to be high. An awareness campaign was devised by radiology residents to inform the local population about this new screening tool, to gauge community members’ reactions to the

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new guidelines and measure their propensity to get screened.

WHAT WE DID Radiology residents at a large, urban medical school-affiliated hospital manned a booth at a medical student-run local health fair to inform the local community on lung cancer screening programs for adults (ages 55 to 80 years who have a 30 pack-year smoking history and either currently smoke or have quit smoking within the past 15 years). The residents explained the indications and the research behind the new recommendation, and the risks and benefits of the screening test. They then administered a short questionnaire regarding participants’ understanding of the screening test and their likelihood of getting screened or recommending the test to a loved one at risk (Online questionnaire). Only the participants’ first answers were recorded. Posters and pamphlets were used as visual aids. The survey gauged the reaction to the recommendation, understanding of the new guidelines, and an individual’s inclination to get screened. A total of 69 fair attendees took the survey.

THE OUTCOMES AND THEIR IMPLICATIONS Participants who stopped by the lung cancer screening booth at Community Care Day were eager to speak with the radiology residents and learn about the new US Preventive Services Task Force initial recommendations. Most (86.9%;

60 of 69) were not aware of the new screening recommendations. Participants who were aware of the screening program (13.1%; 9 of 69) all stated that they were health care workers. Evidence-based medicine has demonstrated that low-dose CT screening can significantly reduce mortality and morbidity associated with lung cancer in high-risk patients. However, most people are not aware of this new recommendation and therefore do not request screening and do not recommend that family and friends at high risk for lung cancer be screened. This finding is consistent with a small study performed by Whitten et al [5], in which >56% of patients who received screening had not done so earlier because they did not know such recommendations existed. We have demonstrated that a simple educational activity that takes

US Preventive Services Task Force CT lung cancer screening recommendations: community awareness and perceptions.

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