Attitudes of Clinicians about Screening Head and Neck Cancer Survivors for Lung Cancer Using Low-Dose Computed Tomography

Kimberly Dukes, Aaron T. Seaman, Richard M. Hoffman, Alan J. Christensen, Nicholas Kendell, Andrew L. Sussman, Miriam Vélez-Bermúdez, Robert J. Volk, Nitin A. Pagedar

Research output: Contribution to journalArticle

Abstract

Objective: National guidelines recommend lung cancer screening (LCS) using low-dose computed tomography (LDCT) for high-risk patients, including survivors of other tobacco-related cancers like head and neck cancer (HNC). This qualitative study investigated clinicians’ practices and attitudes toward LCS with LDCT with patients who have survived HNC, in the context of mandated requirements for shared decision making (SDM) using decision aids. Methods: Thematic analysis of transcribed semi-structured clinician interviews and focus group. Results: Clinicians recognized LCS’ utility for some HNC survivors with smoking histories. However, they identified many challenges to SDM in diverse clinic settings, including time, workflow, uncertainty about guidelines and reimbursement, decision aids, competing patient priorities, unclear evidence, potentially heightened patient receptivity and stress, and the complexity of discussions. They also identified challenges to LCS implementation. Conclusions: While clinicians feel that LDCT LCS may benefit some HNC survivors, there are barriers both to implementing LCS SDM for these patients in primary care as currently recommended and to integrating it into cancer clinics. Challenges for SDM across settings include a lack of decision aids tailored to patients with cancer histories. Given recommendations to broaden LCS eligibility criteria, more research may be required before refinement of current guidelines.

Original languageEnglish (US)
Pages (from-to)23-31
Number of pages9
JournalAnnals of Otology, Rhinology and Laryngology
Volume129
Issue number1
DOIs
StatePublished - Jan 1 2020

Fingerprint

Head and Neck Neoplasms
Early Detection of Cancer
Survivors
Lung Neoplasms
Tomography
Decision Support Techniques
Decision Making
Guidelines
Workflow
Focus Groups
Uncertainty
Tobacco
Neoplasms
Primary Health Care
Smoking
Interviews
Research

Keywords

  • decision making
  • early detection of cancer
  • head and neck neoplasms
  • lung neoplasms
  • qualitative research
  • shared

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Dukes, K., Seaman, A. T., Hoffman, R. M., Christensen, A. J., Kendell, N., Sussman, A. L., ... Pagedar, N. A. (2020). Attitudes of Clinicians about Screening Head and Neck Cancer Survivors for Lung Cancer Using Low-Dose Computed Tomography. Annals of Otology, Rhinology and Laryngology, 129(1), 23-31. https://doi.org/10.1177/0003489419868245

Attitudes of Clinicians about Screening Head and Neck Cancer Survivors for Lung Cancer Using Low-Dose Computed Tomography. / Dukes, Kimberly; Seaman, Aaron T.; Hoffman, Richard M.; Christensen, Alan J.; Kendell, Nicholas; Sussman, Andrew L.; Vélez-Bermúdez, Miriam; Volk, Robert J.; Pagedar, Nitin A.

In: Annals of Otology, Rhinology and Laryngology, Vol. 129, No. 1, 01.01.2020, p. 23-31.

Research output: Contribution to journalArticle

Dukes, K, Seaman, AT, Hoffman, RM, Christensen, AJ, Kendell, N, Sussman, AL, Vélez-Bermúdez, M, Volk, RJ & Pagedar, NA 2020, 'Attitudes of Clinicians about Screening Head and Neck Cancer Survivors for Lung Cancer Using Low-Dose Computed Tomography', Annals of Otology, Rhinology and Laryngology, vol. 129, no. 1, pp. 23-31. https://doi.org/10.1177/0003489419868245
Dukes, Kimberly ; Seaman, Aaron T. ; Hoffman, Richard M. ; Christensen, Alan J. ; Kendell, Nicholas ; Sussman, Andrew L. ; Vélez-Bermúdez, Miriam ; Volk, Robert J. ; Pagedar, Nitin A. / Attitudes of Clinicians about Screening Head and Neck Cancer Survivors for Lung Cancer Using Low-Dose Computed Tomography. In: Annals of Otology, Rhinology and Laryngology. 2020 ; Vol. 129, No. 1. pp. 23-31.
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