Asymptomatic often sent for lung cancer screening tests

Using questionnaires completed by 962 family physicians, general practitioners, and general internists, Carrie N. Klabunde, Ph.D., of the National Cancer Institute in Bethesda, Md., and associates assessed primary care physicians' knowledge of lung cancer screening guidelines, beliefs about screening, and ordering of tests. Intentions to screen asymptomatic 50-year-old patients with varying smoking histories for the disease were assessed by use of clinical vignettes.

The researchers found that, during 2006 to 2007, 38 percent ordered no lung cancer screening tests, and 55, 22, and less than 5 percent ordered chest radiographs, low-dose spiral computed tomography, and sputum cytology tests, respectively, for asymptomatic patients. In multivariate modeling, physicians who were more likely to have ordered these tests were those who believed that expert groups recommended screening or that screening was effective, those whose usual practice was to recommend screening for asymptomatic patients (including those without substantial smoking exposure), and those whose patients asked about screening.

"Our findings that a majority of primary care physicians reported ordering lung cancer screening tests for asymptomatic patients and that patients have recently asked them about lung cancer screening suggest that ordering of these tests is common among these physicians," the authors write. "At the time of the survey, lung cancer screening was not recommended by major expert groups in the United States."

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