Assessment of compliance with USPSTF lung cancer screening guidelines among resident primary care physicians in a university residency program.

Authors

Nerea Lopetegui-Lia

Nerea Lopetegui-Lia

University of Connecticut Health Center, Farmington, CT

Nerea Lopetegui-Lia, Syed Imran Jafri, Manish Kumar, Shashank Sama, James J. Vredenburgh

Organizations

University of Connecticut Health Center, Farmington, CT, University of Connecticut Health Center/Neag Comprehensive Cancer Center, Farmington, CT, Univeristy of Connecticut Health Center, Farmington, CT, St Francis Hospital and Medical Group, Hartford, CT

Research Funding

No funding received
None.

Background: Lung cancer remains the leading cause of morbidity and mortality, with a predicted 1.8 million deaths worldwide yearly. The United States Preventive Services Task Force (USPSTF) recommends screening for lung cancer with Low Dose Computed Tomography (LDCT) for all genres of age 55 to 80 with a 30 pack-year smoking history, current smokers or have quit within the past 15 years. Early detection has shown to reduce mortality. Only 4% of eligible patients in the US actually undergo lung cancer screening. Methods: A retrospective review of data was performed amongst the University of Connecticut Internal Medicine Residents acting as PCPs at a Clinic in Hartford, CT, USA. Results: 369 medical charts were reviewed. 115 patients (31.1%) met the USPSTF criteria for screening. 5.7% had an appropriately ordered LDCT scan. 2.71% had a LDCT completed and 2.98% had LDCT scheduled but pending or cancelled. 4 patients with smoking history who did not meet USPSTF criteria but had a LDCT due to clinical suspicion for lung cancer. Approximately 11% of patients had chronic obstructive pulmonary disease (COPD) or emphysema and asthma. 5 patients had a first degree relative with history of lung cancer. 6 patients had lung cancer, 3 of which had metastatic lung cancer at the time of diagnosis and are deceased. Conclusions: Lung cancer screening amongst resident PCP is insufficient. The results obtained were lower than the national average. This is likely due to newer trainees focusing less in prevention/screening and more on managing chronic medical conditions. Patients that attend resident PCP clinics in the US are typically of lower socio-economic status, less insurance coverage or uninsured and with a lower level of education. LDCT orders that were cancelled were likely because insurers declined it. Patients not realizing the importance of screening could also be contributing. It is unclear if lung disease or family history attributes a higher risk of developing lung cancer. In conclusion, educating resident PCPs and patients on lung cancer screening, as well as evaluating the reasons for cancelling LDCT could help ensure high quality care.

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Abstract Details

Meeting

2019 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session A: Cost, Value, and Policy; Health Equity and Disparities

Track

Cost, Value, and Policy,Health Care Access, Equity, and Disparities

Sub Track

Guideline-Concordant Care Initiatives

Citation

J Clin Oncol 37, 2019 (suppl 27; abstr 43)

DOI

10.1200/JCO.2019.37.27_suppl.43

Abstract #

43

Poster Bd #

D6

Abstract Disclosures

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